the impact of hiv/aids on the education sector in tanzania

MoEC
Government <strong>of</strong> Tanzania IIEP – UNESCO
THE IMPACT OF HIV/AIDS
ON THE EDUCATION SECTOR
IN TANZANIA
Study 1
EXPLORING POLICY, LEADERSHIP
AND ADVOCACY RESPONSES
Athanas S. Kauzeni – Team Leader
Clement Kihinga – Associate Researcher
January, 2004

ACKNOWLEDGEMENTS
The successful completion <strong>of</strong> this study is due to <strong>the</strong> contribution <strong>of</strong> many people, to
whom we wish to express our deep gratitude. Without <strong>the</strong>ir contribution and hard work, we
would not have obtained <strong>the</strong>se results. We hope that this study will provide essential
information with respect to <strong>the</strong> <strong>impact</strong> <strong>of</strong> HIV/AIDS on <strong>the</strong> education sector in <strong>the</strong> areas <strong>of</strong>
policy, advocacy and leadership in Tanzania.
To cite a very long list <strong>of</strong> acknowledgements may seem hackneyed. However, after
spending several months carrying out research and compiling <strong>the</strong> findings, <strong>the</strong> authors <strong>of</strong> this
report have become truly indebted to numerous people, and public and private institutions.
The report authors and <strong>the</strong> research team are sincerely and deeply indebted to <strong>the</strong>
International Institute for Educational Planning (UNESCO/IIEP) for funding <strong>the</strong> project,
identifying and assigning <strong>the</strong> core research team and fielding periodic expert missions to
support <strong>the</strong> various workshops and phases <strong>of</strong> research design, implementation and evaluation.
The authors wish to pay a special tribute to <strong>the</strong> education sector as a whole and
particularly to <strong>the</strong> leadership <strong>of</strong> <strong>the</strong> Ministry <strong>of</strong> Education and Culture (MoEC) for allowing
research to be undertaken in <strong>the</strong> Ministry, and for <strong>the</strong> moral and physical support in terms <strong>of</strong>
manpower and co-operation from MoEC headquarters, regional and district <strong>of</strong>fices, primary
and secondary schools and from affiliated institutions.
The core research team wishes to thank everyone who took part in <strong>the</strong> study, as an
informant or respondent, for sharing information and <strong>the</strong>ir perspectives on <strong>the</strong> issues
discussed.
Last but not least, <strong>the</strong> core research team wishes to record its appreciation <strong>of</strong> <strong>the</strong>
research results validation mini-workshop participants for <strong>the</strong>ir valuable contribution to <strong>the</strong>
improvement <strong>of</strong> <strong>the</strong> writing <strong>of</strong> <strong>the</strong> report.
Obviously, much as many people share <strong>the</strong> credit for <strong>the</strong> study, especially <strong>the</strong> research
team members, <strong>the</strong> limitations <strong>of</strong> <strong>the</strong> report are <strong>the</strong> responsibility <strong>of</strong> <strong>the</strong> authors. They humbly
accept <strong>the</strong> blame for its flaws.
i

FOREWORD
THE COLLABORATIVE ACTION RESEARCH PROGRAMME
IIEP and its partner ministries <strong>of</strong> education launched <strong>the</strong> collaborative action research
programme in 2003. This initiative is designed to contribute to mitigation and prevention <strong>of</strong>
<strong>the</strong> <strong>impact</strong> <strong>of</strong> <strong>the</strong> HIV/AIDS pandemic in three countries – Malawi, Tanzania and Uganda.
The focus <strong>of</strong> <strong>the</strong> research activities is essentially needs assessment. This, in turn, will help to
prioritize options for <strong>the</strong> development <strong>of</strong> policy, training and o<strong>the</strong>r measures to enable <strong>the</strong>
education sector to streng<strong>the</strong>n its internal capacity in two critical areas. These are to respond
to <strong>the</strong> <strong>impact</strong> <strong>of</strong> <strong>the</strong> epidemic on its staff at all levels and to maintain progress towards EFA
goals.
Objectives
The collaborative action research programme is designed to achieve <strong>the</strong> following
objectives:
� to identify problems related to <strong>the</strong> <strong>impact</strong> <strong>of</strong> HIV/AIDS on <strong>the</strong> education sector and to
prioritise areas for action;
� to formulate responses to gaps identified in current policy, leadership practices and
management capacities;
� to develop a database to track patterns and trends in HIV/AIDS-related teacher and
student absence, abandonment and mortality;
� to formulate effective mitigation and prevention measures based on a qualitative
assessment <strong>of</strong> <strong>the</strong> <strong>impact</strong> <strong>of</strong> HIV/AIDS on selected schools and <strong>the</strong>ir surrounding
communities.
Expected results
The programme is expected to produce results on two levels. Initial activities will
produce five diagnostic studies and recommendations for specific responses to <strong>the</strong> <strong>impact</strong> <strong>of</strong>
<strong>the</strong> epidemic on <strong>the</strong> education sector. The first two studies will be carried out in all three
countries. The final three studies will be implemented selectively. The studies will examine
<strong>the</strong> <strong>impact</strong> <strong>of</strong> HIV/AIDS on <strong>the</strong> following areas: educational leadership and policy;
educational governance; enrolment, attendance and instruction in district schools; selected
schools and communities, and tertiary educational institutions. This phase will also lead to
<strong>the</strong> production <strong>of</strong> a handbook <strong>of</strong> research tools, policy recommendations and best practices, to
facilitate replication <strong>of</strong> <strong>the</strong> research programme in o<strong>the</strong>r countries.
As <strong>the</strong> research progresses, <strong>the</strong> needs identified in <strong>the</strong> diagnosis stage will be used to
formulate policy frameworks and recommendations, and training and organisational
development strategies. The ministries <strong>of</strong> education <strong>of</strong> <strong>the</strong> co-operating countries will
implement, monitor and evaluate <strong>the</strong>se strategies, in partnership with IIEP and o<strong>the</strong>r technical
and financial partners in <strong>the</strong> donor community.
iii

TABLE OF CONTENTS
Acknowledgements i
Foreword – <strong>the</strong> collaborative action research programme iii
Table <strong>of</strong> contents v
List <strong>of</strong> abbreviations and acronyms vii
List <strong>of</strong> tables ix
List <strong>of</strong> figures ix
Executive summary 1
1 Background 5
1.1 Introduction 5
1.2 Justification for <strong>the</strong> study 5
1.3 Conceptual framework 6
1.4 Objectives 7
1.5 Research questions 7
1.6 Selection <strong>of</strong> study area and samples 8
1.7 Primary data collection techniques 11
2 Magnitude <strong>of</strong> <strong>the</strong> HIV/AIDS problem 13
2.1 The global picture 13
2.2 The national HIV/AIDS situation 14
2.3 The HIV/AIDS situation in <strong>the</strong> education sector 19
3 Evolution <strong>of</strong> <strong>the</strong> HIV/AIDS interventions in <strong>the</strong> education sector 21
3.1 National policy on HIV/AIDS 21
3.2 Education sector HIV/AIDS policy 22
3.3 Implementation <strong>of</strong> HIV/AIDS interventions in <strong>the</strong> education sector 26
3.4 Policy and practices supported by o<strong>the</strong>r education sector actors 28
3.5 Problems in implementing interventions 31
3.6 Additional problems 34
4 Leadership and advocacy 35
4.1 Internal advocacy for policy development and implementation <strong>of</strong> interventions 35
4.2 External advocacy for policy development and implementation <strong>of</strong>
interventions 36
4.3 Visible gaps in leadership and advocacy 36
4.4 Steps needed to create a conducive environment for effective leadership and
advocacy 37
5 Conclusions and recommendations 39
5.1 Policy 39
5.2 Leadership 40
5.3 Advocacy 41
v

References 43
Appendices 45
1 A list <strong>of</strong> people interviewed 45
2 Groups <strong>of</strong> people who participated in focus group discussions 47
3 Tanzania research and results validation teams 49
vi

LIST OF ABBREVIATIONS AND ACRONYMS
ACU AIDS Coordination Unit
AIDS Acquired Immunodeficiency Syndrome
AMC AIDS Management Committee
AMREF African Medical Research Foundation
ARV Antiretroviral
BAKWATA Muslim Council <strong>of</strong> Tanzania
BEDC Basic Education Development Committee
CBOs Community-Based Organizations
CEO Chief Education Officer
CSSC Christian Social Services Commission
EFA Education for All
EMIS Education Management Information System
ESSP Education Sector Strategic Plan
FBOs Faith-Based Organizations
FGDs Focus group discussions
GTZ Germany Agency for Technical Cooperation
HIV Human Immunodeficiency Virus
IDYDC Iringa Development <strong>of</strong> Youth Disabled and Children Care
IEC Information Education and Communication
IIEP International Institute for Educational Planning
INGONET Iringa AIDS NGO Network
MoEC Ministry <strong>of</strong> Education and Culture
MoH Ministry <strong>of</strong> Health
MTP Medium-Term Plan
NACP National AIDS Control Programme
NGOs Non-Governmental Organizations
PLWHA People Living With HIV/AIDS
PORALG President’s Office for Regional Administration and Local Government
SPW Students Partnership Worldwide
STIs Sexually Transmitted Infections
TAC Technical AIDS Committee
TACAIDS Tanzania Commission for HIV/AIDS
TAHEA Tanzania Home Economics Association
TAPA Tanzania Parents Association
TSC Teachers Service Commission
TTU Tanzania Teachers Union
UMATI Uzazi na Malezi Bora Tanzania
UNAIDS Joint United Nations programme on HIV/AIDS
UNDP United Nations Development Programme
UNESCO United Nations Educational, Scientific and Cultural Organization
VCT Voluntary Counselling and Testing
WHO World Health Organization
vii

LIST OF TABLES
2.1 The global situation <strong>of</strong> <strong>the</strong> HIV/AIDS epidemic at <strong>the</strong> end <strong>of</strong> 2002 13
2.2 Cumulative AIDS cases by region, Tanzania 1993-2001 16
2.3 Distribution <strong>of</strong> reported AIDS cases by age and sex, Tanzania 2001 18
2.4 Percentage distribution <strong>of</strong> deaths <strong>of</strong> teachers by age group, financial year
2001/2002 20
3.1 Education sector HIV/AIDS policy evolution 23
3.2 The evolution <strong>of</strong> <strong>the</strong> AIDS Coordination Unit (ACU) <strong>of</strong> <strong>the</strong> MoEC 25
3.3 Partnerships established in Iringa Urban District 29
LIST OF FIGURES
1.1 Map <strong>of</strong> Tanzania, showing regional boundaries 10
2.1 Cumulative AIDS cases in Iringa Region, compared with <strong>the</strong> national average
and <strong>the</strong> regions with <strong>the</strong> highest and lowest prevalence, 1993-2001 17
ix

EXECUTIVE SUMMARY
This is an <strong>impact</strong> study, which examines policy framework, leadership commitment,
political willingness and advocacy issues on HIV/AIDS, as well as <strong>the</strong> implementation <strong>of</strong>
HIV/AIDS interventions in <strong>the</strong> education sector. It is expected to contribute to a better
understanding <strong>of</strong> <strong>the</strong> role and importance <strong>of</strong> a comprehensive and effective HIV/AIDS
education policy, <strong>of</strong> committed leadership and <strong>of</strong> firm and consistent advocacy against <strong>the</strong>
HIV/AIDS epidemic.
HIV/AIDS continues to spread despite <strong>the</strong> use <strong>of</strong> leadership advocacy among <strong>the</strong>
Tanzanian population to raise general awareness <strong>of</strong> <strong>the</strong> severity <strong>of</strong> <strong>the</strong> epidemic and
knowledge <strong>of</strong> how HIV transmission can be prevented, and also in spite <strong>of</strong> <strong>the</strong> presence <strong>of</strong> a
national policy for <strong>the</strong> control and prevention <strong>of</strong> HIV/AIDS.
The study was undertaken because <strong>the</strong> HIV/AIDS epidemic has emerged as a major
threat to achieving Education for All (EFA) goals. Moreover no study carried out to date has
considered <strong>the</strong> <strong>impact</strong> <strong>of</strong> HIV/AIDS on policy, leadership and advocacy.
Research was carried out in Iringa Urban District, Ministry <strong>of</strong> Education and Culture
(MoEC) headquarters and some <strong>of</strong> its affiliated institutions in Dar es Salaam. At MoEC
headquarters data and information were collected from seven heads <strong>of</strong> departments or
directors, and mid-level MoEC <strong>of</strong>ficials from all directorates, including administrators,
technical staff and peer educators. Interviews were also conducted with low-level MoEC staff,
including messengers, cleaners and print assistants from all directorates. At <strong>the</strong> regional and
district levels interviews were held with <strong>the</strong> Regional Education Officer, District Education
Officer, District School Inspector, Acting Treasurer Iringa Urban District Council, District
Medical Offer, District Teachers Union Secretary, Ward Education Coordinator, Iringa Urban
District Council, Mayor and District Executive Director.
Data collection techniques used include structured and unstructured interviews, focus
group discussions (FGDs), checklists and a literature review.
Globally <strong>the</strong> HIV/AIDS epidemic has proved to be much more extensive than
predicted and is now reaching alarming levels. Almost every passing year sees a revision
upwards <strong>of</strong> estimates and projections. At <strong>the</strong> end <strong>of</strong> 2002, 5.0 million people were newly
infected with HIV, 42 million people were living with HIV/AIDS and 3.1 million people had
died as a result <strong>of</strong> AIDS. By <strong>the</strong> end <strong>of</strong> 2001 <strong>the</strong>re were 14 million AIDS orphans (UNAIDS
and WHO, 2002).
The first HIV/AIDS case in Tanzania was diagnosed in 1983 in Bukoba District <strong>of</strong>
Kagera Region. By 1986 <strong>the</strong> number <strong>of</strong> AIDS cases had risen from <strong>the</strong> initial three to tens <strong>of</strong>
thousands countrywide. At <strong>the</strong> end <strong>of</strong> 2001 <strong>the</strong>re were 14,449 cumulative AIDS cases. Most
cases fall within <strong>the</strong> 20-49 age group, with <strong>the</strong> highest number <strong>of</strong> reported cases in <strong>the</strong> 25-34
and 30-39 age groups for females and males respectively. However, infection rates are
declining in some regions (e.g. Kagera Region): a sign <strong>of</strong> hope that <strong>the</strong> devastating epidemic
can be brought under control.

The education sector is one <strong>of</strong> <strong>the</strong> largest employers in Tanzania. It is particularly
vulnerable to HIV/AIDS, perhaps more so than o<strong>the</strong>r sectors. Epidemiological reports show
that <strong>the</strong> 15-24 age group is highly vulnerable to HIV, whilst demographic surveys indicate
that HIV/AIDS is <strong>the</strong> greatest cause <strong>of</strong> mortality amongst adults in mainland Tanzania. One
<strong>of</strong> <strong>the</strong> main causes for teacher attrition is death: in <strong>the</strong> year 2001/2002 <strong>the</strong>re were 1,046 deaths
<strong>of</strong> teachers, with 517 deaths for <strong>the</strong> first half <strong>of</strong> 2002/2003.
There are critical information gaps in <strong>the</strong> literature with regard to <strong>the</strong> epidemic. The
national policy on HIV/AIDS is silent on such crucial issues as legislation with respect to
HIV/AIDS control and prevention, and personnel matters such as care for infected and
affected teachers (e.g. how medical expenses, and funeral and burial costs are handled).
Information regarding political will and <strong>the</strong> leadership commitment at central, regional,
district and institutional levels is also inadequate.
The absence <strong>of</strong> HIV/AIDS issues from <strong>the</strong> current education and training policy
(Tanzania MoEC, 1995) poses a serious challenge to <strong>the</strong> MoEC. In <strong>the</strong> absence <strong>of</strong> a sectoral
policy upon which to formulate legislation and develop a strategic framework, current
approaches are nei<strong>the</strong>r sufficient nor effective for addressing HIV/AIDS in a wider context, or
developing mechanisms for <strong>the</strong> coordination <strong>of</strong> activities and accountability at sectoral level.
The MoEC currently operates within <strong>the</strong> framework <strong>of</strong> <strong>the</strong> national policy on
HIV/AIDS. The Tanzania Commission for HIV/AIDS (TACAIDS) was established to
provide leadership and coordination <strong>of</strong> a multi-sectoral response to HIV/AIDS. The national
policy was formulated to enforce this leadership role. It outlines <strong>the</strong> framework, direction and
general principles <strong>of</strong> <strong>the</strong> national response interventions.
The day-to-day work <strong>of</strong> <strong>the</strong> MoEC in <strong>the</strong> prevention <strong>of</strong> HIV/AIDS is guided by nonformal
policy documents, namely circulars, directives and guidelines. The MoEC established
HIV/AIDS interventions in <strong>the</strong> education sector, through Circular No. 3 <strong>of</strong> 1993 and 2000
respectively (Tanzania MoEC 1993; 2000). As a result <strong>of</strong> <strong>the</strong>se circulars AIDS education was
incorporated into a number <strong>of</strong> carrier subjects and interventions were expanded to cover all
employees <strong>of</strong> <strong>the</strong> MoEC at <strong>the</strong> central, regional, district and institutional levels. The
management and coordination <strong>of</strong> programme activities were also streng<strong>the</strong>ned. Specifically,
six interventions were implemented:
2
� streng<strong>the</strong>ning <strong>the</strong> HIV/AIDS management structure;
� school HIV/AIDS and life skills education;
� school peer education;
� school guidance and counselling committees;
� school guidance and counselling services, and
� MoEC headquarters peer education.
The resulting school-based activities were implemented at <strong>the</strong> district level by Non-
Governmental Organizations (NGOs) and Community-Based Organizations (CBOs).
However, gaps relating to policy, leadership and advocacy were encountered at all levels. In
order to adequately address <strong>the</strong>se gaps, <strong>the</strong> following measures need to be implemented:
� The MoEC should formulate a sector-specific policy on HIV/AIDS as part <strong>of</strong> a revised
education and training policy. Policy development should be participatory and interactive
in nature.

� MoEC peer educators should be provided with information education and communication
(IEC) materials to support work with clients. As recognition <strong>of</strong> <strong>the</strong>ir services and as
additional motivation, <strong>the</strong> MoEC should also explore <strong>the</strong> possibility <strong>of</strong> giving <strong>the</strong>m token
incentives.
� Education sector leaders need to be sensitized to <strong>the</strong> importance <strong>of</strong> AIDS education
interventions and oriented towards <strong>the</strong> framework for a multi-sectoral response to
HIV/AIDS.
� The MoEC management information system needs to be revised regarding skills,
equipment and focus, so that it includes HIV/AIDS indicators. The improved Educational
Management Information System (EMIS) will <strong>the</strong>n be able to respond to <strong>the</strong> <strong>impact</strong> <strong>of</strong>
HIV/AIDS in <strong>the</strong> sector.
� The current avenues used by <strong>the</strong> education sector to advocate for prevention and control
<strong>of</strong> HIV/AIDS and <strong>impact</strong> mitigation need to be assessed as to <strong>the</strong>ir effectiveness. More
channels for HIV/AIDS advocacy should be explored, and <strong>the</strong> level <strong>of</strong> utilization <strong>of</strong> <strong>the</strong>
mass media should be maximized.
3

1.1 Introduction
1. BACKGROUND
The overall research project on <strong>the</strong> <strong>impact</strong> <strong>of</strong> HIV/AIDS in <strong>the</strong> education sector in
Tanzania has been divided into five areas <strong>of</strong> study:
� educational policy, leadership and advocacy;
� educational governance;
� enrolment, attendance and instruction;
� selected schools and communities in Iringa Urban District, and
� tertiary education institutions.
The present study analyses <strong>the</strong> <strong>impact</strong> <strong>of</strong> HIV/AIDS on <strong>the</strong> education sector and
assesses <strong>the</strong> sectoral and multi-sectoral responses to <strong>the</strong> HIV/AIDS pandemic, for example,
how policies are being implemented for teacher recruitment and training and how <strong>the</strong>se
activities have changed in response to <strong>the</strong> epidemic. The study also explores <strong>the</strong> roles <strong>of</strong>
different actors in providing leadership and advocacy on HIV/AIDS issues, on aspects <strong>of</strong> <strong>the</strong>
organizational climate and on practices that favour or hinder <strong>the</strong> dissemination <strong>of</strong> information
on HIV/AIDS.
The project is a collaborative venture between <strong>the</strong> Ministry <strong>of</strong> Education and Culture
(MoEC) and <strong>the</strong> International Institute for Educational Planning (IIEP), which is part <strong>of</strong> <strong>the</strong>
United Nations Educational Scientific and Cultural Organization (UNESCO).
1.2 Justification for <strong>the</strong> study
There is a particular need for a study <strong>of</strong> this nature on <strong>the</strong> Tanzanian education sector
for four principal reasons:
� The epidemic has emerged as a major threat to achieving Education for All (EFA) goals.
Therefore, responding to <strong>the</strong> epidemic is now an urgent priority, since it affects <strong>the</strong>
delivery <strong>of</strong> education (i.e. supply, demand, quality and quantity).
� No study has been conducted in Tanzania to date to consider <strong>the</strong> <strong>impact</strong> <strong>of</strong> HIV/AIDS on
policy, leadership and advocacy.
� The number <strong>of</strong> orphaned school children is on <strong>the</strong> increase.
� The education sector is <strong>the</strong> main instrument for developing future human resources.
Therefore, <strong>the</strong> teaching pr<strong>of</strong>ession and its management must be protected against <strong>the</strong>
HIV/AIDS pandemic.
5

1.3 Conceptual framework
This study covers three concepts: policy, leadership and advocacy. All three are key to
driving effective interventions. Government involvement is crucial in <strong>the</strong> fight against
HIV/AIDS, in terms <strong>of</strong> appropriate HIV/AIDS policy formulation, leadership commitment in
<strong>the</strong> prevention and control <strong>of</strong> <strong>the</strong> epidemic and strong advocacy.
1.3.1 Policy
Formulation <strong>of</strong> an appropriate and effective HIV/AIDS education policy will guide <strong>the</strong>
implementation <strong>of</strong> education programmes, projects and strategies geared to <strong>the</strong> prevention and
control <strong>of</strong> HIV/AIDS in <strong>the</strong> education sector. There are no easy quantitative or qualitative
criteria for what constitutes appropriate planning for AIDS or for how an AIDS policy should
be integrated into national planning, policy and budget systems, at both <strong>the</strong> macro and micro
levels.
The national policy on HIV/AIDS was launched in November 2001. It provides <strong>the</strong>
framework, direction and general principles <strong>of</strong> <strong>the</strong> national response interventions in three
focus areas:
6
� prevention <strong>of</strong> transmission <strong>of</strong> HIV;
� care and support for those infected and affected by <strong>the</strong> virus, and
� mitigation <strong>of</strong> <strong>the</strong> <strong>impact</strong> <strong>of</strong> <strong>the</strong> epidemic.
The national policy has highlighted <strong>the</strong>se areas in order to convey something <strong>of</strong> <strong>the</strong>
complexity <strong>of</strong> <strong>the</strong> situation in which an education sector policy must be developed and
implemented. The policy must be sensitive to <strong>the</strong> cross-sectoral <strong>impact</strong> <strong>of</strong> <strong>the</strong> epidemic; <strong>the</strong>
social, ethical, legal, cultural and economic issues associated with it require differential
responses from all <strong>of</strong> <strong>the</strong> affected sectors.
1.3.2 Leadership
Leadership commitment is critical for spearheading <strong>the</strong> effective and efficient
implementation <strong>of</strong> HIV/AIDS interventions. In <strong>the</strong> context <strong>of</strong> this study, this commitment
may be manifested through public speeches, circulars or o<strong>the</strong>r information that outlines
priorities. Leadership may also be manifested through proactive HIV/AIDS policy
formulation, <strong>the</strong> structural reorganization <strong>of</strong> <strong>the</strong> education sector or <strong>the</strong> provision <strong>of</strong> adequate
funding for HIV/AIDS activities. Shellukindo, Muhondwa, Lyimo, Tibakweitira and Seikh
(2000) argue that any leader who fails to view AIDS as a serious threat to <strong>the</strong> economy <strong>of</strong> <strong>the</strong>
country, or as having a serious <strong>impact</strong> on <strong>the</strong> health and social welfare <strong>of</strong> <strong>the</strong> people, cannot
be expected to devise and implement policies that seek to create an environment that is
supportive <strong>of</strong> <strong>the</strong> attempts <strong>of</strong> ordinary people to protect <strong>the</strong>mselves against HIV infection.
Similarly, an elected leader who dare not speak out against cultural practices that ostensibly
contribute to HIV transmission, for fear <strong>of</strong> annoying <strong>the</strong> electorate, cannot be an effective ally
in <strong>the</strong> fight against HIV/AIDS. Strong leadership is required if behaviour is to change and if
<strong>the</strong> spread <strong>of</strong> <strong>the</strong> epidemic at <strong>the</strong> national level is to be brought under control.
In Tanzania HIV/AIDS has been declared a national disaster, one that senior figures,
like <strong>the</strong> President and <strong>the</strong> Prime Minister, are keen to engage with. The Prime Minister has
directed that HIV/AIDS be placed on <strong>the</strong> agenda for all meetings. However, few

parliamentarians are supportive in public. It appears that <strong>the</strong>re is much talking, but as <strong>of</strong> yet
little action in <strong>the</strong> fight against HIV/AIDS.
1.3.3 Advocacy
Advocacy can be defined as “<strong>the</strong> promotion <strong>of</strong> activities or policies in defence <strong>of</strong> <strong>the</strong>
interests <strong>of</strong> a particular group” (United Nations, 1995). UNESCO (2002) states that <strong>the</strong>
critical factor in creating an effective strategy for <strong>the</strong> prevention and control <strong>of</strong> HIV/AIDS is
<strong>the</strong> massive, unfailing and unrelenting advocacy and support <strong>of</strong> political authorities at <strong>the</strong>
highest national level. UNESCO’s view is that if <strong>the</strong> epidemic is to be confronted, <strong>the</strong>
message to <strong>the</strong> people must be valid, must be effectively disseminated and must be acted
upon.
The lack <strong>of</strong> firm, consistent and visible advocacy in <strong>the</strong> education sector’s machinery
creates an environment that fails to promote appropriate individual, communal and national
responses to <strong>the</strong> epidemic. In this particular case, it is <strong>the</strong> leadership within <strong>the</strong> education
sector that has to play <strong>the</strong> main advocacy role. Given <strong>the</strong> pivotal role <strong>of</strong> <strong>the</strong> MoEC to national
development, advocacy groups from outside <strong>the</strong> education system can only provide
complementary support.
The general public should be fully informed about HIV/AIDS and should be
empowered against it, with those most at risk targeted as a priority. However, it appears that
<strong>the</strong>re is low public awareness <strong>of</strong> <strong>the</strong> disease and its effects, especially in rural areas.
Campaigns using <strong>the</strong> spoken and written word favour urban over rural areas, since literacy
levels are higher in <strong>the</strong> former. O<strong>the</strong>r communication media (e.g. radio, television and
meetings <strong>of</strong> leaders) are also concentrated in urban areas, which tend to be more affluent than
rural districts.
1.4 Objectives
The general aim <strong>of</strong> <strong>the</strong> study is to examine policy, leadership and advocacy issues in
terms <strong>of</strong> HIV/AIDS <strong>impact</strong> in <strong>the</strong> education sector. The specific objectives <strong>of</strong> <strong>the</strong> study are:
� to examine <strong>the</strong> HIV/AIDS policy framework in <strong>the</strong> education sector;
� to assess <strong>the</strong> leadership commitment to fighting <strong>the</strong> HIV/AIDS pandemic in <strong>the</strong>
education sector;
� to examine advocacy issues pertaining to fighting <strong>the</strong> HIV/AIDS pandemic in <strong>the</strong>
education sector;
� to examine <strong>the</strong> implementation <strong>of</strong> HIV/AIDS interventions in <strong>the</strong> education sector,
and
� to collect information that will be used to enrich <strong>the</strong> education sector HIV/AIDS
strategic framework.
1.5 Research questions
� In <strong>the</strong> absence <strong>of</strong> a formal HIV/AIDS policy in <strong>the</strong> education sector, how does <strong>the</strong> MoEC
carry out HIV/AIDS interventions?
7

� How did <strong>the</strong> national policy on HIV/AIDS evolve?
� How has <strong>the</strong> national policy been affected by HIV/AIDS?
� What kinds <strong>of</strong> HIV/AIDS interventions are implemented at <strong>the</strong> different levels <strong>of</strong> <strong>the</strong>
education sector?
� What problems have been encountered during <strong>the</strong> implementation <strong>of</strong> HIV/AIDS
interventions in <strong>the</strong> education sector?
� What are <strong>the</strong> perceptions <strong>of</strong> various education sector stakeholders regarding issues related
to HIV/AIDS policy, leadership and advocacy?
� What gaps still remain in HIV/AIDS interventions in <strong>the</strong> education sector?
� What internal advocacy mechanisms exist in <strong>the</strong> education sector for policy development
and <strong>the</strong> implementation <strong>of</strong> interventions?
� What external advocacy mechanisms exist in <strong>the</strong> education sector for policy development
and <strong>the</strong> implementation <strong>of</strong> interventions?
� What gaps exist in visible leadership and advocacy in <strong>the</strong> education sector in terms <strong>of</strong>
HIV/AIDS programme implementation?
� What steps need to be taken to create an ideal environment for policy development,
leadership and advocacy?
1.6 Selection <strong>of</strong> study area and samples
1.6.1 Study area
The areas selected for research were MoEC headquarters, <strong>the</strong> headquarters <strong>of</strong>
education sector stakeholders and one district in mainland Tanzania.
The choice <strong>of</strong> district was reached by considering three factors: <strong>the</strong> documented deaths
<strong>of</strong> teachers for <strong>the</strong> years 2001/2002 and <strong>the</strong> first half <strong>of</strong> 2002/2003 (Tanzania Teachers
Service Commission, 2003); <strong>the</strong> documented HIV/AIDS prevalence in Tanzania (Tanzania
Ministry <strong>of</strong> Health, 2002), and access issues relating to budgetary constraints.
Data from <strong>the</strong> Tanzania Teachers Service Commission (TSC) and Ministry <strong>of</strong> Health
(MoH) reports indicate that:
8
� <strong>of</strong> <strong>the</strong> 1,096 deaths <strong>of</strong> teachers reported in 2001/2002 and 517 deaths reported in halfyear
2002/2003, more than half (57 per cent and 60 per cent respectively) were among
men. Among <strong>the</strong>se deaths, <strong>the</strong> regions with <strong>the</strong> highest rates were Mbeya (143) and
Iringa (135), accounting for 18.1 per cent <strong>of</strong> all teachers’ deaths;
� <strong>of</strong> <strong>the</strong> 1,096 deaths <strong>of</strong> teachers reported in 2001/2002, more than two-fifths (42 per
cent) would appear to have been HIV/AIDS related (i.e. causes <strong>of</strong> death included

HIV/AIDS, tuberculosis, long-term fever, cancers etc.). In Mbeya Region 35 deaths
(33 per cent) were HIV/AIDS related, whilst in Iringa Region 74 deaths (73 per cent)
were HIV/AIDS related;
� <strong>the</strong> prevalence <strong>of</strong> HIV among male blood donors in 2001 was highest in six regions:
Kagera (23 per cent); Dar es Salaam (18.8 per cent); Iringa (17.9 per cent); Arusha
(17.2 per cent); Morogoro (16.2 per cent), and Mbeya (14.4 per cent);
� <strong>the</strong> prevalence <strong>of</strong> HIV among female blood donors in 2001 was highest in three
regions: Dar es Salaam (31.4 per cent); Morogoro (22.3 per cent), and Iringa (21.4 per
cent);
� amongst blood donors in <strong>the</strong> 15-24 age group (which gives an approximate indication
<strong>of</strong> <strong>the</strong> number <strong>of</strong> new infections), HIV prevalence was above 10 per cent in Arusha,
Dar es Salaam, Iringa, Kagera, Mbeya, Morogoro, Rukwa and Ruvuma Regions;
� in 1990, 24 antenatal sentinel sites were established in 11 <strong>of</strong> <strong>the</strong> 20 regions <strong>of</strong>
mainland Tanzania. Among antenatal clinic attendees in 2000 <strong>the</strong> prevalence <strong>of</strong> HIV
was above 15 per cent at some sentinel sites in Iringa (32 per cent), Mwanza (16 per
cent), Mbeya (23 per cent), Morogoro (18 per cent) and Kilimanjaro (17 per cent).
In view <strong>of</strong> this data, coupled with <strong>the</strong> budgetary constraints, <strong>the</strong> research team
suggested Dar es Salaam, Iringa and Arusha Regions as candidate research areas. This
proposal was tabled during a meeting with MoEC <strong>of</strong>ficials.
It was decided not to use Dar es Salaam, since <strong>the</strong> MoEC wanted to compile more
information from o<strong>the</strong>r regions outside <strong>of</strong> <strong>the</strong> capital. Considerations <strong>of</strong> costs suggested that
Arusha (850 km from Dar es Salaam) should also be rejected. Therefore Iringa (600 km from
Dar es Salaam) was retained as a study site (see Figure 1.1).
9

Figure 1.1 Map <strong>of</strong> Tanzania, showing regional boundaries
Source: Perry-Castañeda Library Map Collection, <strong>the</strong> General Libraries, <strong>the</strong> University <strong>of</strong> Texas at Austin, 2003.
Of <strong>the</strong> six districts <strong>of</strong> Iringa Region, it was ultimately decided to use Iringa Urban.
The decision was partly based on logistical considerations: for example, Makete Region had
poor communications (high relief and impassable roads in <strong>the</strong> rainy seasons), whilst Iringa
Rural was undergoing administrative restructuring. It was also felt that Iringa Urban provided
a representative sample, since it encompasses both rural and urban areas, with <strong>the</strong> rural
population making up approximately one third <strong>of</strong> <strong>the</strong> total district population.
10

1.6.2 Study samples
Structured and unstructured interviews were conducted with six heads <strong>of</strong> departments
at MoEC headquarters. The senior <strong>of</strong>ficials were <strong>the</strong> Director <strong>of</strong> Basic Education, <strong>the</strong> Director
<strong>of</strong> Administration and Personnel, <strong>the</strong> Director <strong>of</strong> Policy and Planning, <strong>the</strong> Director <strong>of</strong>
Secondary Education, <strong>the</strong> Director <strong>of</strong> School Inspections and <strong>the</strong> Director <strong>of</strong> Cultural
Development.
Focus group discussions (FGDs) were conducted with o<strong>the</strong>r MoEC staff. The sessions
involved mid-level staff, peer educators and low-level staff, drawn from every directorate (see
Appendix 2 for a breakdown <strong>of</strong> <strong>the</strong> numbers). The peer educators included administrators and
technical staff only, whereas <strong>the</strong> low-level staff included messengers, cleaners and print
assistants, in order to canvas as broad a range <strong>of</strong> experience and opinion as possible.
Structured and unstructured interviews, toge<strong>the</strong>r with supplementary unstructured
information-ga<strong>the</strong>ring sessions were conducted with eight senior <strong>of</strong>ficials working with
MoEC partner institutions. The senior <strong>of</strong>ficers were <strong>the</strong> TACAIDS Director <strong>of</strong> Policy and
Planning, <strong>the</strong> head <strong>of</strong> <strong>the</strong> Information Education Communication (IEC) unit at <strong>the</strong> National
AIDS Control Programme (NACP), <strong>the</strong> Director <strong>of</strong> <strong>the</strong> Christian Social Services Commission
(CSSC), <strong>the</strong> President <strong>of</strong> Tanzania Teachers Union (TTU), <strong>the</strong> Executive Secretary <strong>of</strong> <strong>the</strong>
TSC, <strong>the</strong> Education Secretary <strong>of</strong> <strong>the</strong> Tanzania Parents Association (TAPA), <strong>the</strong> Education
Officer <strong>of</strong> <strong>the</strong> Muslim Council <strong>of</strong> Tanzania (BAKWATA) and <strong>the</strong> Education Officer with <strong>the</strong>
Agha Khan Education Foundation.
The same interview and information ga<strong>the</strong>ring techniques were used to collect data
from regional and district level <strong>of</strong>ficers. The Regional Education Officer, Iringa Urban
District Council Mayor, District Executive Director, District Education Officer, District
School Inspector, District Medical Officer and <strong>the</strong> District Teachers Union Secretary were all
questioned, along with, two directors <strong>of</strong> Non-Governmental Organizations (NGOs) and three
NGO programme <strong>of</strong>ficers.
Four secondary schools and five primary schools were involved in institutional level
research. Headmasters, headmistresses and headteachers were interviewed separately, as were
two ward education coordinators (see Appendix 1 for more details). A total <strong>of</strong> 25 in-school
FGDs were held, involving 81 teachers, and 159 secondary school students and primary
school pupils. Male and female students and pupils were consulted separately (see Appendix
2 for a breakdown <strong>of</strong> <strong>the</strong> groups).
1.7 Primary data collection techniques
Primary data collection was accomplished by using four different techniques.
1.7.1 Unstructured information ga<strong>the</strong>ring sessions
Unstructured sessions were conducted with all senior <strong>of</strong>ficials, for <strong>the</strong> ga<strong>the</strong>ring <strong>of</strong>
information on matters such as <strong>the</strong> organizational culture <strong>of</strong> <strong>the</strong> institutions under
consideration. The sessions took place in a variety <strong>of</strong> settings, <strong>of</strong>ten outside <strong>the</strong> working
environment, and were subject to far less advance preparation than <strong>the</strong> more formal
interviews. This meant that <strong>the</strong>y <strong>of</strong>fered maximum flexibility to pursue information in
11

whatever direction appeared to be most appropriate, with most <strong>of</strong> <strong>the</strong> questions flowing from
<strong>the</strong> immediate context. Follow-up contact was made with several respondents for <strong>the</strong>
clarification and elaboration <strong>of</strong> issues raised in <strong>the</strong> original meeting.
1.7.2 Structured and unstructured interviews
This method <strong>of</strong> data collection was used to collect information from all senior <strong>of</strong>ficials
and educators. The tools designed for this study utilized a combination <strong>of</strong> more and less
structured interview techniques, followed with extended interview sessions to elaborate on
certain areas.
1.7.3 Focus group discussions (FGDs)
FGDs utilized strong group dynamics in order to solicit information on specific subtopics,
over <strong>the</strong> course <strong>of</strong> a guided conversation. They were conducted with peer educators,
middle-level and junior support staff at MoEC headquarters, teachers, students and pupils.
The groups were small, with <strong>the</strong> number <strong>of</strong> participants ranging from 6 to 10 people. The
participants usually had similar backgrounds with respect to <strong>the</strong> topic under discussion. Each
discussion took one to two hours.
1.7.4 Checklists
Checklists were used to document <strong>the</strong> IEC materials used at MoEC headquarters. At
regional, district and institutional levels <strong>the</strong>y were used to establish <strong>the</strong> degree <strong>of</strong> access to
copies <strong>of</strong> <strong>the</strong> Education and Training Policy <strong>of</strong> 1995, along with any additional circulars and
guidelines. They were also drawn up following interviews to work out <strong>the</strong> issues that needed
fur<strong>the</strong>r elaboration.
12

2.1 The global picture
2. MAGNITUDE OF THE HIV/AIDS PROBLEM
Globally <strong>the</strong> HIV/AIDS epidemic has reached alarming levels. It has proved to be
much more extensive than predicted: every passing year sees a revision upwards <strong>of</strong> estimates
and projections. In 1991 <strong>the</strong> World Health Organization (WHO) expected that by <strong>the</strong> year
2000 some 20 million individuals worldwide would be infected with <strong>the</strong> Human
Immunodeficiency Virus (HIV). That prediction was almost three times short <strong>of</strong> <strong>the</strong> mark. By
<strong>the</strong> end <strong>of</strong> 2001, almost 22 million people had already died <strong>of</strong> <strong>the</strong> disease, whilst more than
40 million adults and children were living with HIV/AIDS (UNESCO, 2002).
Recent estimates indicate that by <strong>the</strong> end <strong>of</strong> 2002 42 million people were living with
HIV/AIDS, <strong>of</strong> whom 38.6 million were in <strong>the</strong>ir most productive years, that is between <strong>the</strong>
ages <strong>of</strong> 15 and 49, and 3.2 million were children aged 15 years or younger (UNAIDS and
WHO, 2002). The worldwide infection rate stood at 0.4 per cent. In 2002 alone, 5 million
people (including 800,000 children) became infected with HIV/AIDS and 3.1 million died <strong>of</strong>
AIDS (see Table 2.1).
Table 2.1 The global HIV/AIDS situation at <strong>the</strong> end <strong>of</strong> 2002
People newly infected with
HIV
Number <strong>of</strong> people living with
HIV/AIDS
Total
Adults
Women
Children under 15 years
Total
Adults
Women
Children under 15 years
AIDS-related deaths Total
Adults
Women
Children under 15 years
Number <strong>of</strong> AIDS orphans
since <strong>the</strong> beginning <strong>of</strong> <strong>the</strong>
epidemic until <strong>the</strong> end <strong>of</strong> 2001
Source: UNAIDS and WHO, 2002
5.0 million
4.2 million
2.0 million
800,000
42.0 million
38.6 million
19.2 million
3.2 million
3.1 million
2.5 million
1.2 million
610,000
Total 14 million
About half <strong>of</strong> all people living with HIV/AIDS (PLWHA) became infected before <strong>the</strong>
age <strong>of</strong> 25 and died approximately 10 years later. By <strong>the</strong> end <strong>of</strong> 2001 <strong>the</strong>re was a cumulative
13

total <strong>of</strong> 14 million AIDS orphans (defined as children who have lost <strong>the</strong>ir mo<strong>the</strong>rs before
reaching <strong>the</strong> age <strong>of</strong> 15). Many <strong>of</strong> <strong>the</strong>se maternal orphans however, had also lost <strong>the</strong>ir fa<strong>the</strong>rs.
Approximately 95 per cent <strong>of</strong> <strong>the</strong> global number <strong>of</strong> PLWHA live in developing countries
(Amani, 2003). It is expected that this proportion will rise fur<strong>the</strong>r, as a result <strong>of</strong> poverty, poor
health systems and <strong>the</strong> limited resources available for prevention and care. With <strong>the</strong> HIVpositive
population still expanding, <strong>the</strong> annual number <strong>of</strong> AIDS deaths worldwide can also be
expected to increase.
It is very likely that <strong>the</strong> situation will deteriorate fur<strong>the</strong>r before <strong>the</strong>re is any
improvement. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has warned
that <strong>the</strong> damage already incurred will seem minor compared with that which lies ahead, unless
action against <strong>the</strong> epidemic is scaled up dramatically. Fur<strong>the</strong>rmore, HIV/AIDS continues to
spread rapidly into new populations, particularly in Africa, Asia, <strong>the</strong> Caribbean and Eastern
Europe. A recent report (Gordon, 2002) predicts that <strong>the</strong> spread <strong>of</strong> <strong>the</strong> disease will accelerate
in Asia and Africa over <strong>the</strong> next decade, with <strong>the</strong> possibility that by 2010 <strong>the</strong>re will be
75 million people living with HIV/AIDS in five <strong>of</strong> <strong>the</strong> world’s most populous countries (i.e.
China, India, Russia, Ethiopia and Nigeria).
Although <strong>the</strong> most direct consequences <strong>of</strong> <strong>the</strong> spread <strong>of</strong> HIV/AIDS are <strong>the</strong> increases in
morbidity and mortality, in severely affected countries <strong>the</strong> epidemic has already led to
significant economic, social and security setbacks. The adverse effects <strong>of</strong> <strong>the</strong> epidemic ripple
out across society, leaving no sector untouched. It is a comprehensive tragedy that calls for a
comprehensive response (UNAIDS and WHO, 2002).
2.2 The national HIV/AIDS situation
Like many o<strong>the</strong>r sub-Saharan countries, <strong>the</strong>re is a relatively high level <strong>of</strong> HIV/AIDS
infection in Tanzania. The first case was diagnosed in 1983 in a village on <strong>the</strong> Ugandan
border in Bukoba District <strong>of</strong> Kagera Region. By 1986 <strong>the</strong> number <strong>of</strong> AIDS cases had risen
from an initial three to number tens <strong>of</strong> thousands countrywide.
According to a 1991 NACP report, by 1990 Tanzania had 21,175 <strong>of</strong>ficially reported
AIDS cases, <strong>of</strong> which more than 90 per cent were in adults between 15 and 55 years <strong>of</strong> age. In
a 1997 report on HIV prevalence among antenatal clinic attendees, <strong>the</strong> figures ranged from
4 to 44 per cent (UNAIDS and Economic Commission for Africa, 2000).
Table 2.2 shows <strong>the</strong> cumulative AIDS cases since 1993. It is worth noting that <strong>the</strong>
distribution <strong>of</strong> AIDS cases by region is based on where <strong>the</strong> diagnosis was made and <strong>the</strong>refore
does not necessarily reflect <strong>the</strong> place <strong>of</strong> usual residence <strong>of</strong> <strong>the</strong> person. High prevalence in
Mbeya might <strong>the</strong>refore reflect <strong>the</strong> region’s high number <strong>of</strong> migrant workers. In addition, <strong>the</strong>
NACP estimates that only one out <strong>of</strong> five AIDS cases are reported, due to under-utilization <strong>of</strong>
health services, under-reporting and delays in reporting. Despite <strong>the</strong>se limitations however, it
is believed that <strong>the</strong> data do reflect <strong>the</strong> trend <strong>of</strong> cases in <strong>the</strong> country.
The table shows that until 1998, compared with <strong>the</strong> rest <strong>of</strong> <strong>the</strong> country Iringa had just
over <strong>the</strong> average number <strong>of</strong> cases <strong>of</strong> HIV – approximately 5 per cent <strong>of</strong> <strong>the</strong> total cases in
Tanzania. From 1998 onwards however, <strong>the</strong> rate <strong>of</strong> growth in Iringa was much slower
compared to <strong>the</strong> country as a whole, so that by 2001 only 3.7 per cent <strong>of</strong> <strong>the</strong> total number <strong>of</strong>
AIDS cases were found in <strong>the</strong> region. This is mainly due to <strong>the</strong> explosion in <strong>the</strong> number <strong>of</strong>
14

cases in Mbeya Region (see Figure 2.1 for a graphical representation <strong>of</strong> this). In addition to
hosting a large number <strong>of</strong> migrant workers, Mbeya borders both Zambia and Malawi and has
a major railroad running through it. All <strong>of</strong> <strong>the</strong>se factors conspire to produce a situation where
<strong>the</strong>re is a high degree <strong>of</strong> population movement, in o<strong>the</strong>r words, a situation in which HIV can
spread very rapidly. Dar es Salaam also has a large number <strong>of</strong> PLWHA, although since it is a
major urban centre, it is expected that prevalence will be higher than average. The lowest
prevalence rates are found in Mara and Rukwa. In <strong>the</strong> case <strong>of</strong> Mara, this partly reflects <strong>the</strong>
small size <strong>of</strong> <strong>the</strong> region. Rukwa is much larger and although it has a low overall prevalence
compared with <strong>the</strong> national average, <strong>the</strong> rate <strong>of</strong> increase is higher than even in Iringa. One
possible explanation <strong>of</strong> <strong>the</strong> low number <strong>of</strong> cases is that <strong>the</strong>re are fewer screening centres in
Rukwa compared to o<strong>the</strong>r regions. Therefore, <strong>the</strong> figures may represent a low incidence <strong>of</strong>
diagnosis, ra<strong>the</strong>r than low prevalence.
15

Table 2.2 Cumulative AIDS cases by region, Tanzania 1993-2001
Region
16
Year
1993 1994 1995 1996 1997 1998 1999 2000 2001
Arusha 2,185 2,368 2,615 2,787 3,244 3,567 3,948 4,196 4,688
Coast 2,740 3,023 3,268 3,559 3,796 4,266 4,375 5,348 5,580
Dar es
Salaam
10,406 11,050 11,302 12,983 13,899 14,517 14,643 16,053 18,627
Dodoma 1,028 1,294 1,608 1,938 2,517 2,641 2,748 2,941 3,170
Iringa 4,462 4,674 4,785 4,883 5,008 5,031 5,076 5,179 5,298
Kagera 6,646 7,064 7,223 7,426 7,671 7,881 8,310 8,529 8,976
Kigoma 1,920 2,070 2,257 2,280 2,426 2,481 2,613 2,732 2,815
Kilimanjaro 4,699 5,119 5,513 5,991 6,618 7,375 7,766 8,088 9,097
Lindi 1,691 1,966 2,173 2,480 2,712 3,074 3,559 4,155 4,710
Mara 1,304 1,393 1,486 1,486 1,486 1,515 1,634 2,021 2,229
Mbeya 11,439 12,214 12,371 14,685 16,835 19,949 23,688 26,952 30,320
Morogoro 4,328 4,575 4,903 5,189 5,438 5,534 5,863 6,388 6,820
Mtwara 2,090 2,201 2,267 2,444 2,569 2,843 3,000 3,262 3,638
Mwanza 5,349 5,731 5,974 6,365 7,006 7,384 7,884 8,338 8,752
Rukwa 715 777 801 882 1,227 1,359 1,621 1,997 2,382
Ruvuma 2,480 2,847 3,087 3,345 3,752 4,260 4,760 5,406 6,381
Shinyanga 2,624 3,062 3,361 3,824 4,217 4,515 4,861 5,440 6,310
Singida 1,472 1,688 1,908 2,135 2,167 2,262 2,329 2,396 2,692
Tabora 2,786 3,075 3,428 3,805 4,278 4,733 5,199 5,946 6,349
Tanga 3,207 3,475 3,793 4,062 4,278 4,632 4,792 4,975 5,620
Unspecified 1 2 44 44 44 44 44 44 44
Total for
Tanzania
Source: Amani, 2003
73,572 79,668 84,167 92,593 101,188 109,863 118,713 130,386 144,498

Figure 2.1 Cumulative AIDS cases in Iringa Region, compared with <strong>the</strong>
national average and <strong>the</strong> regions with <strong>the</strong> highest and lowest prevalence,
1993-2001
Number <strong>of</strong> cases
35 000
30 000
25 000
20 000
15 000
10 000
5 000
0
1993 1994 1995 1996 1997 1998 1999 2000 2001
Year
Dar es Salaam Iringa Mara Mbeya Rukwa Average
Source: Data from Figure 2.2
Table 2.3 shows <strong>the</strong> age and sex distribution <strong>of</strong> <strong>the</strong> reported cases in 2001. Most fall
within <strong>the</strong> 20-49 age group, with <strong>the</strong> highest number <strong>of</strong> reported cases in <strong>the</strong> 25-34 and 30-39
age groups for females and males respectively. Assuming a medical incubation period <strong>of</strong>
around ten years, this pattern suggests that most individuals acquire <strong>the</strong> infection during late
adolescence (Amani, 2003). It also confirms that <strong>the</strong> productive and reproductive age group is
<strong>the</strong> hardest hit by <strong>the</strong> disease.
The data in Table 2.3 also show that women in <strong>the</strong> 20-34 age group have a higher
prevalence rate than men <strong>of</strong> <strong>the</strong> same age. However, males generally have a higher case rate
than females, particularly for those aged 35 years and over. The information currently
available indicates that women tend to become infected far younger than men, for both
biological and cultural reasons. Amani (2003) reports that according to recent studies <strong>of</strong>
several African populations, girls aged 15-19 are five to six times more likely to be HIV
positive than boys <strong>of</strong> <strong>the</strong> same age.
17

Table 2.3 Distribution <strong>of</strong> reported AIDS cases by age and sex, Tanzania
2001
Age
group
18
Male Female Unknown Total
No. % No. % No. % No. %
0-4 198 3.2 186 2.4 4 10.0 388 2.7
5-9 116 1.9 101 1.3 6 15.0 223 1.6
10-14 66 1.1 91 1.2 0 0.0 157 1.1
15-19 139 2.2 418 5.4 1 2.5 558 4.0
20-24 479 7.7 1,095 14.0 8 20.0 1,582 11.2
25-29 894 14.3 1,656 21.2 2 5.0 2,552 18.1
30-34 1,247 19.9 1,710 21.9 6 15.0 2,963 21.0
35-39 1,131 18.1 1,135 14.5 4 10.0 2,270 16.1
40-44 809 12.9 662 8.5 3 7.5 1,474 10.4
45-49 479 7.7 346 4.4 2 5.0 827 5.9
50-54 306 4.9 191 2.4 4 10.0 501 3.6
55-59 157 2.5 91 1.2 0 0.0 248 1.8
60-64 123 2.0 59 0.8 0 0.0 182 1.3
65+ 85 1.4 22 0.3 0 0.0 107 0.8
Unknown 32 0.5 48 0.6 0 0.0 80 0.6
Total 6,261 100.0 1 7,811 100.0 40 100.0 14,112 100.0
Source: Tanzania MoH, 2001
However, <strong>the</strong>re are signs <strong>of</strong> hope that this devastating epidemic can be brought under
control. In countries such as Uganda and South Africa <strong>the</strong> situation does seem to be
improving. In several regions <strong>of</strong> Uganda, <strong>the</strong> number <strong>of</strong> HIV infections appears to be on <strong>the</strong>
decline: <strong>the</strong>re is a steady drop in HIV prevalence among 15-19 year-old pregnant women
(Rugalema and Khanye, 2002). In South Africa HIV prevalence rates among pregnant women
under 20 fell from 21 per cent in 1998 to 15.4 per cent in 2001, although overall growth rates
are still increasing. In Tanzania <strong>the</strong> challenge is how to sustain <strong>the</strong> low prevalence rates <strong>of</strong>
some regions, whilst decreasing <strong>the</strong> current high prevalence rates in o<strong>the</strong>rs (e.g. Mbeya, Dar
es Salaam and Kilimanjaro). NACP documents indicate that <strong>the</strong> pattern <strong>of</strong> infection is also
changing, as a result <strong>of</strong> greater coverage in Voluntary Counselling and Testing (VCT),
coupled with <strong>the</strong> increased use <strong>of</strong> antiretroviral (ARV) <strong>the</strong>rapy and higher levels <strong>of</strong> condom
use.
1 If <strong>the</strong> percentages given here are added up, <strong>the</strong> total percentage comes to 100.3. However, this is because <strong>the</strong>
figures have been rounded to 1 d.p., ra<strong>the</strong>r than because <strong>of</strong> any inaccuracy in <strong>the</strong> statistics. For this reason, all <strong>of</strong>
<strong>the</strong> total percentages have been given as 100.0.

2.3 The HIV/AIDS situation in <strong>the</strong> education sector
In <strong>the</strong> education sector <strong>the</strong> prevalence <strong>of</strong> HIV and <strong>the</strong> <strong>impact</strong> <strong>of</strong> AIDS are measured
through a combination <strong>of</strong> indicators, ranging from trends in <strong>the</strong> morbidity and mortality <strong>of</strong>
teachers, to <strong>the</strong> proportion <strong>of</strong> orphans in enrolments. However, record keeping is poor and <strong>the</strong>
data needed to measure <strong>the</strong> indicators are lacking. For example, although <strong>the</strong>re are indications
that AIDS may have become <strong>the</strong> greatest cause <strong>of</strong> death among adults in mainland Tanzania,
empirical data are not yet conclusive about this issue. Estimations <strong>of</strong> AIDS-related mortality
rates can only be proximate: symptoms that point to AIDS or HIV infection, for example
long-term illness and wasting, are also indicative <strong>of</strong> many o<strong>the</strong>r diseases (Bicego, Curtis,
Raggers, Kapiga and Ngallaba, 1997).
The education sector, which is one <strong>of</strong> <strong>the</strong> largest employers in Tanzania, faces
particular problems for two basic reasons:
� Schools and educational institutions enrol young people in <strong>the</strong> 7-24 age group, from basic
education through to tertiary level. Epidemiological reports show that <strong>the</strong> 15-24 age group
is highly vulnerable to HIV (Tanzania MoH, 2001). Data from o<strong>the</strong>r research findings
corroborates this, showing that both girls and boys in primary and secondary schools are
sexually active. A knowledge, attitudes and practices baseline survey conducted by <strong>the</strong>
German Agency for Technical Cooperation (GTZ) Reproductive Health Project amongst
1,560 primary school pupils in Lindi Region indicated that 45 per cent <strong>of</strong> pupils were
sexually active. The mean age for first sexual intercourse was 11.2 years for boys and 14
years for girls (Tautz, 2001).
� If ignored, <strong>the</strong> high rate <strong>of</strong> disease and death among teachers and o<strong>the</strong>r trained
pr<strong>of</strong>essionals will make replacements increasingly hard to find and train. Moreover, <strong>the</strong>
death <strong>of</strong> just one teacher deprives a whole class <strong>of</strong> children <strong>of</strong> education. Therefore, it
erodes access to education and interferes with <strong>the</strong> functioning capacity <strong>of</strong> key institutions.
2.3.1 Cultural practices that increase <strong>the</strong> risk <strong>of</strong> HIV infection
There are a number <strong>of</strong> cultural practices that can increase <strong>the</strong> risk <strong>of</strong> infection among
<strong>the</strong> wider community and that also affect education sector staff, students and pupils. These
include:
� casual sexual intercourse during tribal festivals and social ga<strong>the</strong>rings;
� sexual intercourse to remove curses and taboos;
� sex with minors for <strong>the</strong> purpose <strong>of</strong> curing disease;
� wife inheritance, and
� acceptance <strong>of</strong> sexual intercourse with in-laws.
In addition to <strong>the</strong>se practices, certain factors may put teachers at special risk <strong>of</strong>
contracting HIV, particularly in rural areas. Here, poverty levels are high but teachers are
perceived as well to do and have high social status in <strong>the</strong>ir teaching environment. Receipt <strong>of</strong> a
regular cash income also gives <strong>the</strong>m resources to buy sexual favours in an environment with
little liquidity for most <strong>of</strong> <strong>the</strong> year. Consequently, some interviewees and participants in <strong>the</strong>
discussion groups felt that education sector leaders and teachers lack <strong>the</strong> moral authority to
advocate for HIV/AIDS prevention, because <strong>of</strong> <strong>the</strong>ir own high-risk behaviour.
19

The lack <strong>of</strong> attention given to <strong>the</strong> vulnerability <strong>of</strong> teachers to HIV/AIDS and <strong>the</strong>
inability <strong>of</strong> most to access ARV treatment, mean that many die every year. According to
Galabawa and Mbelle (2002), <strong>the</strong> teaching force is disappearing at a rate <strong>of</strong> 0.8 per cent. Data
from <strong>the</strong> TSC reveals that most teacher attrition caused by death is due to HIV/AIDS and its
related diseases (e.g. TB, typhoid, diarrhoea and long-term fevers). The cumulative number <strong>of</strong>
deaths <strong>of</strong> teachers between January 1999 and December 2002 was 2,873. Of <strong>the</strong>se,
49 (17.3 per cent) occurred in 1999, 708 (24.6 per cent) occurred in 2000, 730 (25.4 per cent)
occurred in 2001 and 938 (32.6 per cent) occurred in 2002, indicating an upward trend.
During <strong>the</strong> financial year 2001/2002, 1,046 deaths <strong>of</strong> teachers were recorded, as Table 2.4
shows.
Table 2.4 Percentage distribution <strong>of</strong> deaths <strong>of</strong> teachers by age group,
financial year 2001/2002
20
Age Category Number Percentage
Under 30 years 71 6.8
31-40 years 219 21.0
41-50 years 603 57.6
Over 50 years 153 14.6
Total 1,046 100.0
Source: Tanzania TSC, 2003.
Taking into account <strong>the</strong> causes <strong>of</strong> death recorded and <strong>the</strong> pr<strong>of</strong>iles <strong>of</strong> terminal diseases,
it is probable that some <strong>of</strong> <strong>the</strong> deaths among teachers aged 30-40 were HIV related. The
majority <strong>of</strong> deaths however, occurred in <strong>the</strong> 41-50 age group. This has two major
implications:
� It is likely that many <strong>of</strong> <strong>the</strong>se older teachers had a high degree <strong>of</strong> experience in <strong>the</strong>
classroom, so <strong>the</strong>ir deaths represent a high level <strong>of</strong> wastage in terms <strong>of</strong> human resources.
� It is likely that by that stage <strong>of</strong> <strong>the</strong>ir lives, many would have established families <strong>of</strong> <strong>the</strong>ir
own, thus adding to <strong>the</strong> burden <strong>of</strong> AIDS orphans.
Therefore, in Tanzania, just as in many o<strong>the</strong>r countries, AIDS has already had an
unprecedented institutional and sectoral <strong>impact</strong>. Moreover, <strong>the</strong> organizations and individuals
that it affects are not only those that are most needed for development; <strong>the</strong>y are also vital for
<strong>the</strong> prevention <strong>of</strong> <strong>the</strong> spread <strong>of</strong> <strong>the</strong> epidemic itself. Education has <strong>the</strong> potential to be <strong>the</strong> single
most powerful weapon at <strong>the</strong> disposal <strong>of</strong> those fighting HIV/AIDS (Kelly, 2000).

3. EVOLUTION OF THE HIV/AID INTERVENTIONS IN THE
EDUCATION SECTOR
3.1 National policy on HIV/AIDS
Tanzania’s national policy on HIV/AIDS has been in place since November 2001. It is
intended to provide a framework for <strong>the</strong> leadership and coordination <strong>of</strong> <strong>the</strong> multi-sectoral
response to <strong>the</strong> epidemic. The policy calls on all sectors to formulate appropriate interventions
to prevent, control and mitigate <strong>the</strong> <strong>impact</strong> <strong>of</strong> HIV/AIDS. The specific objectives are:
� to prevent <strong>the</strong> transmission <strong>of</strong> HIV/AIDS;
� to promote HIV testing;
� to provide a framework <strong>of</strong> care for people living with HIV/AIDS;
� to stipulate sectoral roles and financing mechanisms;
� to promote HIV/AIDS research;
� to advocate for HIV/AIDS legislation, and
� to stipulate cross-cutting issues <strong>of</strong> national interest.
Before 2001 and <strong>the</strong> advent <strong>of</strong> <strong>the</strong> national policy, <strong>the</strong> fight against HIV/AIDS was
guided by <strong>the</strong> NACP. This programme was formed in 1985. Its initial activities were set out in
a two-year short term plan (1985-1986), which was <strong>the</strong>n followed by three successive
Medium-Term Plans (MTPs), each lasting five years (MTP–I 1987-1991, MTP–II 1992-1996
and MTP–III 1998-2002).
The first two MTPs identified national responses to be guided and coordinated by <strong>the</strong>
health sector. MTP–III however, was formulated with an expanded multi-sectoral vision and
called for <strong>the</strong> wider participation <strong>of</strong> both <strong>the</strong> public and private sectors, including NGOs,
Community-Based Organizations (CBOs) and Faith-Based Organizations (FBOs). However
despite this expanded framework, <strong>the</strong> NACP was still viewed principally as a health sector
initiative, incapable <strong>of</strong> coordinating a multi-sectoral response to HIV/AIDS. Therefore, in
2001 TACAIDS was established under <strong>the</strong> Prime Minister’s Office to provide <strong>the</strong> leadership
and coordination <strong>of</strong> such a response. The national policy was formulated to facilitate <strong>the</strong>
ability <strong>of</strong> TACAIDS to assume this rule.
The policy directs central and local government, NGOs, CBOs, FBOs and <strong>the</strong> general
public to develop IEC interventions to promote safe sex practices, including <strong>the</strong> correct and
consistent use <strong>of</strong> condoms. As part <strong>of</strong> this, <strong>the</strong> national policy mandates <strong>the</strong> MoEC to work
closely with TACAIDS and NGOs to accelerate <strong>the</strong> provision <strong>of</strong> HIV/AIDS information in
schools and to promote safe sex amongst staff. Fur<strong>the</strong>r mandates to <strong>the</strong> education sector are
provided in <strong>the</strong> 2003-2007 national multi-sectoral strategic framework on HIV/AIDS, which
calls on all sectors to develop seperate strategic frameworks. In response to this, <strong>the</strong> MoEC
began working on <strong>the</strong> Education Sector Strategic Plan (ESSP) on HIV/AIDS, 2003-2007.
21

3.2 Education sector HIV/AIDS policy
The education sector’s activities are laid out in <strong>the</strong> education and training policy <strong>of</strong>
1995. This policy guides <strong>the</strong> provision <strong>of</strong> education in Tanzania, focussing principally on
increasing enrolments and improving quality, equitable access and resource distribution. It
does not however deal with issues relating to HIV/AIDS.
The cause for <strong>the</strong> lack <strong>of</strong> a dedicated HIV/AIDS policy for <strong>the</strong> education sector and
<strong>the</strong> absence <strong>of</strong> HIV/AIDS from <strong>the</strong> current education and training policy can be traced back to
<strong>the</strong> early categorization <strong>of</strong> <strong>the</strong> epidemic as a health sector issue. During those early years
(1985-1991), <strong>the</strong> education and health sectors did work closely toge<strong>the</strong>r on some issues, for
example, in primary schools to prevent and control <strong>the</strong> spread <strong>of</strong> Sexually Transmitted
Infections (STIs). However, it did not occur to <strong>the</strong> government <strong>of</strong> <strong>the</strong> day that <strong>the</strong> education
sector required an individual response to <strong>the</strong> epidemic. This was still <strong>the</strong> case in 1995 when
<strong>the</strong> education and training policy was finalized.
3.2.1 Initial interventions in <strong>the</strong> education sector
The education sector interventions that have taken place were based on two pivotal
circulars, formulated and released in 1993 and 2000 respectively. Active participation on <strong>the</strong>
part <strong>of</strong> <strong>the</strong> MoEC began in 1993 with <strong>the</strong> release <strong>of</strong> Circular Number 3 for <strong>the</strong> establishment
<strong>of</strong> an HIV/AIDS intervention in <strong>the</strong> education sector. The MoEC subsequently released
Circular Number 3 <strong>of</strong> 2000, to redefine <strong>the</strong> nature and scope <strong>of</strong> those interventions. The
contents <strong>of</strong> <strong>the</strong> two circulars are summarized in Table 3.1.
22

Table 3.1 Education sector HIV/AIDS policy evolution
Education Circular Number 3 <strong>of</strong> 1993
Contents � Establishment <strong>of</strong> an HIV/AIDS intervention in <strong>the</strong> education sector. The major
focus was primary schools and grade A and B teacher training colleges.
� The intervention was designed to educate students and pupils to adopt and
maintain behaviour that would reduce <strong>the</strong> spread <strong>of</strong> HIV.
� The intervention initially adopted a campaign approach, whilst awaiting <strong>the</strong> AIDS
curriculum component to be introduced later. Campaign elements included <strong>the</strong>
dissemination <strong>of</strong> IEC materials (teachers guides, picture charts and flyers etc.) and
running orientation seminars at zonal and district levels.
� NGOs were invited into secondary schools to assist with HIV/AIDS education.
Remarks � The circular directed zonal and district school inspectors to train primary school
teachers in AIDS Education, without stipulating how <strong>the</strong>y were to be trained
<strong>the</strong>mselves.
� The circular did not institute a monitoring and evaluation plan or commit funds for
this activity.
� The circular did not give explicit directions to heads <strong>of</strong> secondary schools to invite
NGOs to extend <strong>the</strong>ir interventions to schools.
� The circular did not provide unified guidance on how <strong>the</strong> activities <strong>of</strong> NGOs in
secondary schools were to be coordinated.
Education Circular Number 3 <strong>of</strong> 2000
The circular redefined <strong>the</strong> nature and scope <strong>of</strong> <strong>the</strong> school HIV/AIDS education intervention. Copies
were distributed to all school heads by <strong>the</strong> regional and district education <strong>of</strong>ficers and it became
effective on 1 December 2000.
Contents � The target group <strong>of</strong> <strong>the</strong> 1993 intervention was expanded to cover teachers and
MoEC employees, in addition to school pupils.
� The intervention was designed to educate <strong>the</strong> target audience to adopt behaviour
and practices that would prevent infections and curb <strong>the</strong> spread <strong>of</strong> HIV/AIDS and
STIs.
� AIDS education was incorporated into carrier subjects ra<strong>the</strong>r than treated as a
separate subject.
� Peer education was advocated as one <strong>of</strong> <strong>the</strong> methods used to educate primary
school pupils, secondary school students and teacher trainees.
� Zonal and district school inspectors were directed to monitor <strong>the</strong> provision <strong>of</strong> inschool
HIV/AIDS education.
� The intervention was teacher centred. Only teachers and trainee teachers were
responsible for delivering in-class AIDS education, although o<strong>the</strong>r experts could
be invited to make special one-<strong>of</strong>f presentations.
� The circular directed that NGOs could be invited to extend <strong>the</strong>ir interventions to
schools after obtaining permission from <strong>the</strong> MoEC, based on submitted proposals.
� Heads <strong>of</strong> schools and teacher training colleges were directed to identify ‘AIDS
days’, dedicated to educating pupils, students and <strong>the</strong> wider school community on
HIV/AIDS issues.
� Heads <strong>of</strong> MoEC departments and institutions affiliated to <strong>the</strong> MoEC were directed
to form HIV/AIDS advisory committees.
� Heads <strong>of</strong> schools and teacher training colleges were directed to form counselling
and education committees.
� Zonal school inspectors were directed to work with o<strong>the</strong>r facilitators to provide
23

24
HIV/AIDS education to schoolteachers, through training and orientation
programmes.
Remarks � There was no consultation with o<strong>the</strong>r actors, such as CBOs, FBOs and PLWHA,
whose experiences and different perspectives could have made a valuable
contribution.
� The circular did not consider how <strong>the</strong> education system should handle orphans, or
how AIDS orphans differ from o<strong>the</strong>rs. AIDS orphans are consequently treated just
like any o<strong>the</strong>r orphan, despite <strong>the</strong>ir specific needs and ever-increasing numbers.
� The circular did not address issues connected with PLWHA, particulary those
related to <strong>the</strong> stigma attached to <strong>the</strong> disease. As a result <strong>of</strong> this omission,
administrators at all levels are forced to rely on common sense only, when such
issues arise amongst <strong>the</strong>ir own staff.
� Unlike district school inspectors, district education <strong>of</strong>ficers did not automatically
receive copies <strong>of</strong> <strong>the</strong> circular, as had been <strong>the</strong> case in 1993. It is <strong>the</strong>refore
suspected that acquisition <strong>of</strong> this circular by district education <strong>of</strong>ficers depended
on <strong>the</strong>ir immediate managers, <strong>the</strong> regional education <strong>of</strong>ficers and district executive
directors.
3.2.2 The AIDS education programme
The release and dissemination <strong>of</strong> <strong>the</strong> circulars culminated in <strong>the</strong> formulation and
implementation <strong>of</strong> <strong>the</strong> AIDS education programme. This programme is divided into six
components:
� Streng<strong>the</strong>ning <strong>the</strong> HIV/AIDS management structure
The circulars called for <strong>the</strong> streng<strong>the</strong>ning <strong>of</strong> <strong>the</strong> HIV/AIDS management structure to
facilitate <strong>the</strong> organization <strong>of</strong> <strong>the</strong> interventions. Two new bodies were formed: <strong>the</strong> AIDS
Management Committee (AMC), and <strong>the</strong> Technical AIDS Committee (TAC). The School
AIDS Education Programme was reformulated, becoming an independent unit, <strong>the</strong> AIDS
Coordination Unit (ACU), located in <strong>the</strong> <strong>of</strong>fice <strong>of</strong> <strong>the</strong> Chief Education Officer (CEO). The
AMC is <strong>the</strong> highest HIV/AIDS management body in <strong>the</strong> MoEC. It is composed <strong>of</strong> <strong>the</strong>
heads <strong>of</strong> departments and institutions and chaired by <strong>the</strong> Permanent Secretary. The TAC is
<strong>the</strong> second highest body and is composed <strong>of</strong> HIV/AIDS focal points nominated by <strong>the</strong>
heads <strong>of</strong> departments and institutions. The two committees are served by a single
secretariat, <strong>the</strong> ACU. The evolution <strong>of</strong> <strong>the</strong> ACU is described in Table 3.2.

Table 3.2 The evolution <strong>of</strong> <strong>the</strong> AIDS Coordination Unit <strong>of</strong> <strong>the</strong> MoEC
Original
inception
The ACU began in 1993 as <strong>the</strong> School AIDS Education Programme, under <strong>the</strong> <strong>of</strong>fice
<strong>of</strong> <strong>the</strong> Commissioner <strong>of</strong> Education (present CEO).
Restructuring In 2001 <strong>the</strong> School AIDS Education programme was upgraded into a full-fledged
HIV/AIDS Coordination Unit, under <strong>the</strong> <strong>of</strong>fice <strong>of</strong> <strong>the</strong> CEO. The unit is supported by
two MoEC steering committees:
� AIDS Management Committee (AMC);
� Technical AIDS Committee (TAC).
Present
function
� Serves as <strong>the</strong> secretariat to <strong>the</strong> AMC and TAC.
� Initiates and coordinates planning for HIV/AIDS- and o<strong>the</strong>r STI-related activities.
� Initiates and harmonizes sector strategic plan activities.
� Coordinates <strong>the</strong> implementation <strong>of</strong> <strong>the</strong> ESSP between <strong>the</strong> various stakeholders.
� Conducts regular supervision and follow-up <strong>of</strong> AIDS education implemented by
departments, institutions and collaborators.
� Prepares consolidated quarterly, mid-year and annual progress reports for
submission to <strong>the</strong> appropriate authorities.
� Mobilizes resources.
� Identifies areas for research and coordinates existing research into <strong>the</strong> <strong>impact</strong> <strong>of</strong>
HIV/AIDS on <strong>the</strong> education sector.
Future role The role <strong>of</strong> <strong>the</strong> HIV/AIDS Coordinating Unit is expected to expand as <strong>the</strong> ESSP
develops. This will necessitate:
� an adequate number <strong>of</strong> qualified staff (education specialists, sociologists, public
health experts etc.);
� adequate supplies and equipment, including data processing equipment,
stationery, IEC materials etc.;
� additional staff training, especially related to HIV/AIDS and monitoring and
evaluation.
� School HIV/AIDS and life skills education
This component <strong>of</strong> <strong>the</strong> HIV/AIDS programme is based in primary and secondary schools
and teacher training colleges. HIV/AIDS, o<strong>the</strong>r STIs and life skills education curriculum
requirements are treated as topics in <strong>the</strong> syllabi <strong>of</strong> carrier subjects: primary science for
primary education; biology for secondary education; civics for <strong>the</strong> Certificate in
Education, and general studies for Advanced Level and <strong>the</strong> Diploma in Education. Inservice
and pre-service training sessions have been provided for teachers. As a result,
80 teacher training college tutors, 1,460 secondary school teachers and 21,000 primary
school teachers nationally have been trained in HIV/AIDS and life skills education.
� School peer education
This component is based at <strong>the</strong> institutional level. Fellow pupils, students and teacher
trainees usually nominate and vote for peer educators, who are <strong>the</strong>n trained. The core
functions <strong>of</strong> peer educators are to promote responsible sexual behaviour and to provide
support against peer pressure.
25

� School guidance and counselling committees
This is a 10 to 12 member sub-committee <strong>of</strong> <strong>the</strong> school committee or board, which
supports, supervises and monitors <strong>the</strong> in-school implementation <strong>of</strong> <strong>the</strong> HIV/AIDS
education programme. The committee is also responsible for coordinating <strong>the</strong> involvement
<strong>of</strong> <strong>the</strong> surrounding community.
� School counselling and guidance services
This component utilizes <strong>the</strong> services <strong>of</strong> teachers, known as guardians, who are trained in
guidance and counselling techniques. Pupils and students can seek advice and assistance
on a wide range <strong>of</strong> issues, including adolescent reproductive health, HIV/AIDS and o<strong>the</strong>r
STIs, sexual abuse and <strong>the</strong> rights <strong>of</strong> <strong>the</strong> child.
� MoEC headquarters peer education
Introduced in February 2003, this is <strong>the</strong> newest component <strong>of</strong> <strong>the</strong> HIV/AIDS education
programme. It utilizes <strong>the</strong> services <strong>of</strong> 65 trained peer educators, selected by popular vote
from all departments at MoEC headquarters and all affiliated institutions. The prospective
educators receive one-week’s training, covering areas <strong>of</strong> sexual behaviour, HIV/AIDS
education, peer education and <strong>the</strong> responsibilities <strong>of</strong> peer educators in <strong>the</strong> workplace. The
peer educators were <strong>the</strong>n given <strong>the</strong> task <strong>of</strong> educating fellow workers on HIV/AIDS and
providing a role model for fellow workers. The majority (80 per cent) came from MoEC
headquarters, with <strong>the</strong> rest from various affiliated institutions (Tanzania Library Services,
<strong>the</strong> TTU, <strong>the</strong> Institute <strong>of</strong> Adult Education, Bagamoyo School <strong>of</strong> Arts, <strong>the</strong> Films
Censorship Board, Baraza la Kiswahili Tanzania, <strong>the</strong> TSC and <strong>the</strong> Tanzania Institute <strong>of</strong>
Education).
3.2.3 Fur<strong>the</strong>r guidelines for HIV/AIDS-related interventions
In October 2002 a document was produced and distributed stipulating fur<strong>the</strong>r
guidelines for <strong>the</strong> implementation <strong>of</strong> HIV/AIDS, o<strong>the</strong>r STIs and life skills education in
schools and teacher training colleges. The guidelines were distributed to all actors in <strong>the</strong>
education sector, with <strong>the</strong> hope that <strong>the</strong>y would reduce <strong>the</strong> extent <strong>of</strong> transmission <strong>of</strong>
HIV/AIDS amongst <strong>the</strong> public in general and in educational institutions in particular. The
document noted that <strong>the</strong> health <strong>of</strong> young people has become a subject <strong>of</strong> increasing
importance in Tanzania, partly because <strong>of</strong> a greater understanding <strong>of</strong> <strong>the</strong> importance <strong>of</strong> this
age group to public health and partly due to <strong>the</strong> changing conditions surrounding sexual and
reproductive health issues.
3.3 Implementation <strong>of</strong> HIV/AIDS interventions in <strong>the</strong> education
sector
Effective implementation <strong>of</strong> HIV/AIDS interventions at all levels <strong>of</strong> <strong>the</strong> education
sector requires <strong>the</strong> full involvement <strong>of</strong> all schools, departments, partners and affiliated
institutions.
3.3.1 Interventions at <strong>the</strong> central level
In addition to <strong>the</strong> specific tasks <strong>of</strong> streng<strong>the</strong>ning <strong>the</strong> HIV/AIDS management structure
and introducing peer education schemes for ministry staff, <strong>the</strong> MoEC is responsible for <strong>the</strong>
26

overall implementation, coordination, monitoring and evaluation <strong>of</strong> <strong>the</strong> six components <strong>of</strong> <strong>the</strong>
AIDS education programme.
All national and local NGOs and CBOs wishing to implement school-based activities
must also be registered with, and cleared by, <strong>the</strong> MoEC.
3.3.2 Interventions at <strong>the</strong> district level
At <strong>the</strong> district level <strong>the</strong> education sector implements MoEC circulars, directives and
guidelines pertaining to <strong>the</strong> interventions. It also collaborates with NGOs, CBOs, FBOs and
o<strong>the</strong>r sectors on HIV/AIDS school-based activities.
This study established that <strong>the</strong> Iringa Regional Education Officer and Iringa Urban
District Education Officer did receive copies <strong>of</strong> <strong>the</strong> 1993 and 2000 circulars, which represent
<strong>the</strong> cornerstones <strong>of</strong> <strong>the</strong> AIDS education programme. The subsequent implementation <strong>of</strong> <strong>the</strong>
stipulated interventions involved:
� arranging training seminars and workshops for teachers, in collaboration with zonal
and district school inspectors. The sessions mostly concentrated on school HIV/AIDS
and life skills education. Carrier subject teachers at primary and secondary schools
received fur<strong>the</strong>r training on how to teach <strong>the</strong> new parts <strong>of</strong> <strong>the</strong> syllabus. Only one
primary and two secondary teachers were trained per school. O<strong>the</strong>r public sector
bodies and NGOs were also invited to make technical presentations on issues relating
to health, community development and social welfare. The local NGOs invited were
Uzazi na Malezi Bora Tanzania (UMATI) and <strong>the</strong> African Medical Research
Foundation (AMREF);
� establishing inter-sectoral collaborations, mainly with <strong>the</strong> health sector, to run
HIV/AIDS interventions in schools. For example, doctors, nurses and health <strong>of</strong>ficers
were invited to schools to make technical presentations;
� identifying NGOs and CBOs to participate in <strong>the</strong> prevention <strong>of</strong> HIV/AIDS and <strong>impact</strong>
mitigation in <strong>the</strong> education sector. The normal arrangement in Iringa Urban District is
for CBOs and NGOs to submit <strong>the</strong>ir proposed school-based work plans and budgets to
<strong>the</strong> district authorities, following clearance from MoEC headquarters. The authorities
analyse <strong>the</strong> proposal, advising changes as necessary and <strong>the</strong>n select <strong>the</strong> school to
participate in, and benefit from, <strong>the</strong> proposed scheme. Of <strong>the</strong> 26 national and local
NGOs working in <strong>the</strong> district, six NGOs – Iringa AIDS NGO Network (INGONET),
Students Partnership Worldwide (SPW), Iringa Development <strong>of</strong> Youth, Disabled and
Children Care (IDYDC), Tanzania Home Economics Association (TAHEA), UMATI
and AMREF – are actively working in district schools. The details <strong>of</strong> <strong>the</strong>ir activities
are summarized in Table 3.3;
� conducting HIV/AIDS sensitization seminars. These seminars involved two to four
secondary school teachers and all headmasters or headmistresses. Unfortunately, not
all primary school head teachers could attend.
27

3.3.3 Interventions at <strong>the</strong> institutional level
Although all secondary school heads received copies <strong>of</strong> <strong>the</strong> two circulars, it was noted
that none <strong>of</strong> <strong>the</strong> primary schools had copies <strong>of</strong> <strong>the</strong>m. The implementation <strong>of</strong> <strong>the</strong> institutional
level interventions stipulated in <strong>the</strong> circulars involved:
28
� integrating HIV/AIDS into <strong>the</strong> school curriculum, following <strong>the</strong> attendance <strong>of</strong> carrier
subject teachers at <strong>the</strong> HIV/AIDS and life skills education seminars;
� establishing HIV/AIDS days (Siku za UKIMWI Shuleni). In collaboration with school
committees and boards, schools identified two days per term to be dedicated to
HIV/AIDS-related activities. These included debates, discussions, drama, choir, art or
games, poems, cultural dances etc. Guests from <strong>the</strong> health sector were also invited to
give talks. Teachers interviewed felt that this intervention worked more successfully at
secondary than at primary level. One possible reason for this difference is that
secondary heads know what is required <strong>of</strong> <strong>the</strong>m at first hand, as <strong>the</strong>y receive <strong>the</strong>ir own
copies <strong>of</strong> <strong>the</strong> circulars. Primary head teachers can only implement what <strong>the</strong>y are
directed to by <strong>the</strong> <strong>of</strong>fice <strong>of</strong> <strong>the</strong> District Education Officer; directives may be coloured
by <strong>the</strong> interpretation <strong>of</strong> someone else. According to some respondents <strong>the</strong> o<strong>the</strong>r reason
is that secondary schools are semi-autonomous authorities and can thus choose to
invite NGOs and CBOs to participate <strong>the</strong>mselves. Primary schools have to depend on
prescriptions from <strong>the</strong> <strong>of</strong>fice <strong>of</strong> <strong>the</strong> District Education Officer;
� establishing in-school peer education interventions. Two peer educators were chosen
from each class (classes V to VII in primary schools, forms I to VI in secondary
schools). Carrier subject teachers, guidance and counselling teachers, NGOs and
CBOs (including UMATI, TAHEA and SPW) <strong>the</strong>n trained those selected;
� establishing STI, including HIV/AIDS counselling and guidance interventions. The
heads <strong>of</strong> schools, in collaboration with district authorities, were involved in <strong>the</strong>
identification <strong>of</strong> teachers to be trained in counselling and guidance. Training was
coordinated by <strong>the</strong> education department, in collaboration with NGOs and CBOs
(UMATI, TAHEA, SPW and AMREF).
3.4 Policy and practices supported by o<strong>the</strong>r education sector
actors
The MoEC collaborates with a number <strong>of</strong> education sector and HIV/AIDS
stakeholders. The partners include TACAIDS, <strong>the</strong> President’s Office for Regional
Administration and Local Government (PORALG), <strong>the</strong> NACP <strong>of</strong> <strong>the</strong> MoH, <strong>the</strong> World Bank,
UNESCO, UNAIDS, <strong>the</strong> United Nations Development Programme (UNDP), <strong>the</strong> United
Nations Children’s Fund, CSSC, <strong>the</strong> Red Cross, <strong>the</strong> Agha Khan Foundation, BAKWATA,
TAPA, TTU and <strong>the</strong> TSC. A number <strong>of</strong> local NGOs also work at <strong>the</strong> regional and district
levels.
TACAIDS supports all MoEC initiatives for <strong>the</strong> development <strong>of</strong> an HIV/AIDS
education sector policy, principally through <strong>the</strong> 2001 national policy and <strong>the</strong> 2003-2007
national multi-sectoral strategic framework. NACP works with <strong>the</strong> MoEC to prepare

HIV/AIDS IEC materials for schools and has steadily supported o<strong>the</strong>r HIV/AIDS education
sector initiatives.
O<strong>the</strong>r partners provide support by implementing AIDS education programmes in
schools. For example, schools owned by BAKWATA, TAPA, <strong>the</strong> Tanzania Episcopical
Conference and <strong>the</strong> Christian Council <strong>of</strong> Tanzania follow <strong>the</strong> national curriculum, tackling
HIV/AIDS issues in carrier subjects as stipulated by Circular Number 3 <strong>of</strong> 2000. CSSC
reported that <strong>the</strong> introduction <strong>of</strong> HIV/AIDS education in church-owned seminary secondary
schools had <strong>the</strong> secondary effect <strong>of</strong> creating a climate <strong>of</strong> more open discussion amongst staff,
most <strong>of</strong> whom were missionaries. HIV/AIDS had formerly been a taboo subject in such
institutions. Table 3.3 summarizes <strong>the</strong> partnerships established at <strong>the</strong> district and institutional
levels.
Table 3.3 Partnerships established in Iringa Urban District
Iringa AIDS NGO Network (INGONET)
Description � Established on 26 April 1994 with <strong>the</strong> objective <strong>of</strong> reducing <strong>the</strong> <strong>impact</strong> <strong>of</strong> HIV/AIDS
and o<strong>the</strong>r STIs in Iringa, through empowering member NGOs to work with
communities.
Schooloriented
activities
O<strong>the</strong>r
activities
� Shows videos on HIV/AIDS and o<strong>the</strong>r STIs to secondary school students.
� Provides HIV/AIDS education for secondary school students.
� Actively participates in school AIDS days, especially in secondary schools.
� Designs, develops, produces and disseminates HIV/AIDS IEC materials (leaflets and
flyers) for schools.
� Provides material support for orphans (school uniforms and exercise books) through
NGOs and CBOs affiliated to INGONET.
� Organizes HIV/AIDS advocacy seminars for public sector staff, including those
working in <strong>the</strong> education sector.
� Offers psychological training to guardians <strong>of</strong> orphans, including schoolteachers.
Remarks � INGONET concentrates on <strong>the</strong> training <strong>of</strong> teachers, so that <strong>the</strong>y can <strong>the</strong>n train <strong>the</strong>
learners, especially at primary school level.
� INGONET is not staffed with an adequate number <strong>of</strong> personnel to implement <strong>the</strong>
interventions. It depends on staff from affiliated NGOs and CBOs.
� In-school INGONET activities were sometimes met with resistance from teachers,
who observed that <strong>the</strong>ir interventions were too open (e.g. talking about condoms,
sexual intercourse etc.).
Students Partnership Worldwide (SPW)
Description � An international educational charity registered in <strong>the</strong> United Kingdom, with
established youth-led programmes in many countries, including Tanzania.
� In Iringa Region, SPW implements two interventions: <strong>the</strong> School Health Education
Programme at secondary level, and <strong>the</strong> Community Resource Programme at primary
level and in <strong>the</strong> wider community.
� In Iringa Urban District SPW concentrates on <strong>the</strong> School Health Education
Programme.
29

Schooloriented
activities
30
� Recruits and trains volunteers to teach a specially designed adolescent sexual and
reproductive health module covering sensitive topics such as teenage relationships,
HIV/AIDS and o<strong>the</strong>r STIs, teenage pregnancy and family planning.
� Places emphasis throughout <strong>the</strong> teaching sessions on <strong>the</strong> development <strong>of</strong> life skills,
employing non-formal education techniques such as debates, role-plays and audiovisual
<strong>aids</strong> to stimulate discussion and active participation.
� Runs one resource room or youth development centre per school. These centres are
stocked with IEC materials from o<strong>the</strong>r NGOs that work with young people.
� Facilitates a wide range <strong>of</strong> sports and artistic clubs during out-<strong>of</strong>-school hours to
keep students active and to fur<strong>the</strong>r develop <strong>the</strong>ir skills.
� Coordinates and organizes four-day intensive youth festivals that <strong>of</strong>fer students a
rare chance to compete with o<strong>the</strong>r schools in arts, sports and leading public
campaigns against HIV/AIDS.
� Participates in <strong>the</strong> training <strong>of</strong> peer educators at secondary level.
� Participates in HIV/AIDS days in secondary schools.
Iringa Development <strong>of</strong> Youth, Disabled and Children Care (IDYDC)
Description � A local NGO founded in 1991 with <strong>the</strong> aim <strong>of</strong> supporting children in need.
� Registered as an Iringa-based NGO in 1994.
Schooloriented
activities
� Provides practical assistance to orphans and children from poor families, by
distributing school uniforms (shorts and shirt or skirt and blouse) and basic
educational supplies. In both 2002 and 2003 1,000 uniforms were distributed to
needy school children, most <strong>of</strong> whom were orphans.
� Sets up and equips football and netball teams and drama groups in schools and <strong>the</strong>
surrounding communities, with <strong>the</strong> objective <strong>of</strong> using games as an entry point for
disseminating information about HIV/AIDS and o<strong>the</strong>r STIs. To date 80 25-person
football squads have been formed in Iringa Urban District. One peer educator has
been trained for each team.
� Designs and disseminates STI including HIV/AIDS and life skills educational
materials aimed at pupils and students aged 6-17 years.
� Encourages school dropouts to return to <strong>the</strong> classroom through a drop-in or open
door programme, in association with Mpango wa Elimu ya Msingi kwa Walioikosa.
Those returning also receive STI and life skills education.
Tanzania Home Economics Association (TAHEA)
Description � Established in 1980 with <strong>the</strong> objective <strong>of</strong> improving <strong>the</strong> quality <strong>of</strong> community life,
particularly for women.
� TAHEA now has branches in all <strong>of</strong> <strong>the</strong> regions <strong>of</strong> mainland Tanzania.
Schooloriented
activities
O<strong>the</strong>r
activities
� Provides training for teachers in peer education techniques. In 2003 12 primary and
12 secondary school teachers were trained as peer education trainers (three per
school). They went on to train 50 peer educators overall.
� Provides in-school psychosocial support to orphans.
� Mitigates <strong>the</strong> <strong>impact</strong> <strong>of</strong> HIV/AIDS by assisting orphans in school. In Iringa Urban
District TAHEA has assisted orphans at 15 primary schools. It has reached
2,250 orphans in <strong>the</strong> region as a whole. Assistance may include paying fees and
providing uniforms, school bags and exercise books.
� Provides psychological training to guardians <strong>of</strong> orphans, including schoolteachers.

Uzazi na Malezi Bora Tanzania (UMATI)
Description � Established in 1957 with <strong>the</strong> core aim <strong>of</strong> providing family planning services.
� UMATI headquarters are in Dar es Salaam. It has zonal <strong>of</strong>fices across Tanzania,
including one in Iringa municipality.
Schooloriented
activities
O<strong>the</strong>r
activities
� Trains secondary school teachers in counselling and guidance techniques and <strong>the</strong>
rights <strong>of</strong> <strong>the</strong> child.
� Trains peer educators at primary schools.
� Develops, produces and disseminates IEC materials (leaflets and flyers) on
adolescent reproductive and sexual health and HIV/AIDS for schools.
� Encourages schoolteachers, students and pupils to check <strong>the</strong>ir HIV status by visiting
<strong>the</strong> UMATI VCT centre in Iringa municipality.
� Participates in school AIDS days at primary and secondary level when invited.
� Runs a VCT centre in Iringa municipality. Services are free for young people
including those still at school and cost 1,000 Tanzanian shillings (TZS) for adults.
African Medical Research Foundation (AMREF)
Description � An independent, non-pr<strong>of</strong>it NGO founded in 1957 with <strong>the</strong> aim <strong>of</strong> improving
healthcare for <strong>the</strong> underserved throughout Africa, through service delivery, training
and research.
� AMREF headquarters are in Nairobi, Kenya. It has country <strong>of</strong>fices in four African
countries, including Tanzania.
� AMREF’s national headquarters are located in Dar es Salaam. There is a regional
branch in Iringa municipality.
Schooloriented
activities
O<strong>the</strong>r
activities
� Trains secondary school teachers in counselling and guidance techniques and in <strong>the</strong>
rights <strong>of</strong> <strong>the</strong> child.
� Trains peer educators at primary level.
� Develops, produces and disseminates IEC materials (leaflets and flyers) on
adolescent reproductive and sexual health and HIV/AIDS for schools.
� Encourages school teachers, students and pupils to check <strong>the</strong>ir HIV status by visiting
<strong>the</strong> ANGAZA VCT Centre owned by AMREF.
� Participates in school AIDS days at primary and secondary schools when invited.
� Runs a VCT centre in Iringa municipality. Services are free for young people,
including those still at school and cost TZS1,000 for adults.
3.5 Problems in implementing interventions
The implementation <strong>of</strong> <strong>the</strong> HIV/AIDS interventions stipulated by <strong>the</strong> 1993 and 2000
circulars has not been without its problems. The same complaints recurred throughout <strong>the</strong>
interviews and discussions that took place at all levels and can be grouped into several broad
<strong>the</strong>mes.
3.5.1 Financial and resource constraints
Financial constraints <strong>impact</strong> on all components and all levels <strong>of</strong> <strong>the</strong> AIDS education
programme. For example, it was felt that <strong>the</strong>re were inadequate resources for <strong>the</strong> training and
31

support <strong>of</strong> subject teachers and peer educators. As a result, peer educators in school and at <strong>the</strong>
MoEC complained that without teaching manuals and instructional materials it was difficult
to lead topical discussions with participants.
3.5.2 Morale
Low staff morale was also found to be a serious problem at all levels <strong>of</strong> <strong>the</strong> education
sector. In addition to <strong>the</strong> funding and resourcing criticisms, those involved in implementing
HIV/AIDS interventions at <strong>the</strong> ‘front line’ (e.g. school AIDS counsellors, subject teachers and
MoEC peer educators), complained that responsibilities had simply been added onto <strong>the</strong>ir
existing tasks, were not reflected in <strong>the</strong>ir job descriptions and were not considered as criteria
for promotion. The resulting motivation and recruitment problems have been fur<strong>the</strong>r
exacerbated by <strong>the</strong> perceived lack <strong>of</strong> informed support and guidance from education
managers. Teachers also feel that <strong>the</strong>y receive minimal attention from <strong>the</strong> pupils <strong>the</strong>mselves.
AIDS is not an examinable subject, so pupils are not motivated to work.
The epidemic itself has also had a negative <strong>impact</strong> on morale. In <strong>the</strong> course <strong>of</strong>
interviews and discussions, staff articulated concerns that nothing substantial was being done
in <strong>the</strong> sector; that <strong>the</strong>re were no comprehensive programmes to control <strong>the</strong> spread and effects
<strong>of</strong> AIDS. It has already been demonstrated that HIV/AIDS depletes <strong>the</strong> education sector
workforce in terms <strong>of</strong> numbers, skills and experience, and affects manpower planning.
Recruitment and training, particularly <strong>of</strong> specialist subject teachers, have not reacted to <strong>the</strong>
<strong>impact</strong> <strong>of</strong> HIV/AIDS on <strong>the</strong> sector. As a result it is likely that posts will not be filled, placing
fur<strong>the</strong>r strain on existing staff.
3.5.3 Coordination and co-operation
Coordination and co-operation are vital for <strong>the</strong> effective implementation <strong>of</strong>
programmes, projects and interventions. However, <strong>the</strong> fieldwork revealed that <strong>the</strong>re were
coordination problems between and amongst <strong>the</strong> different levels <strong>of</strong> <strong>the</strong> MoEC, as well as <strong>the</strong>
o<strong>the</strong>r organizations implicated in <strong>the</strong> interventions. One possible reason for this was that <strong>the</strong>
implementation framework described in <strong>the</strong> HIV/AIDS programme guidelines did not
delineate clearly enough <strong>the</strong> roles and responsibilities <strong>of</strong> <strong>the</strong> different structures within <strong>the</strong>
MoEC at central, regional and district levels, let alone its linkages with partners outside <strong>the</strong>
Ministry (Muhondwa and Mhina, 2003).
NGOs, CBOs and FBOs make a valuable contribution to <strong>the</strong> fight against HIV/AIDS.
However, <strong>the</strong> 2000 circular directed that only teachers and trainee teachers could be
responsible for delivering in-class AIDS education. O<strong>the</strong>r experts could make special
presentations, but only at <strong>the</strong> invitation <strong>of</strong> <strong>the</strong> MoEC. Both teachers and NGO personnel felt
that exclusion <strong>of</strong> NGOs and o<strong>the</strong>r organizations from <strong>the</strong> classroom in this way was
tantamount to reducing <strong>the</strong> number <strong>of</strong> soldiers on <strong>the</strong> battlefield right in <strong>the</strong> middle <strong>of</strong> <strong>the</strong>
fight. NGO participation was fur<strong>the</strong>r limited by poor communications between Dar es Salaam
and <strong>the</strong> regions, slowing down <strong>the</strong> clearance process.
However, where NGOs were active in school, it was observed that <strong>the</strong>ir interventions
were not necessarily complementary to <strong>the</strong> <strong>of</strong>ficial instruction given by teachers (Muhondwa
and Mhina, 2003). In addition to this, some NGO pilot projects did not take into consideration
<strong>the</strong> degree <strong>of</strong> teacher training required or <strong>the</strong> constraints <strong>of</strong> working within <strong>the</strong> structures <strong>of</strong>
<strong>the</strong> education sector, rendering <strong>the</strong>m unworkable or unsustainable.
32

Fur<strong>the</strong>rmore, <strong>the</strong> lack <strong>of</strong> mechanisms for <strong>the</strong> exchange <strong>of</strong> information and ideas also
meant that <strong>the</strong>re was frequent duplication <strong>of</strong> activities between <strong>the</strong> different organizations (see
Table 3.3 for examples), whilst conflicts <strong>of</strong> interest and priorities created additional
coordination issues (Tanzania MoEC, 2001). For example, one source <strong>of</strong> friction was <strong>the</strong>
policy <strong>of</strong> promoting condom use to curb <strong>the</strong> spread <strong>of</strong> HIV. Some FBOs were not prepared to
support this policy and refused to encourage condom use amongst secondary school students.
3.5.4 Disparities in coverage and dissemination
It was found that <strong>the</strong> distribution <strong>of</strong> circulars, directives and policy guidelines was not
satisfactory. Documents sent out to schools by MoEC staff <strong>of</strong>ten could not be located upon
request. It was not clear whe<strong>the</strong>r <strong>the</strong>y had been misplaced or whe<strong>the</strong>r <strong>the</strong>y had simply never
arrived in <strong>the</strong> first place. Such occurrences however, do clearly reduce <strong>the</strong> effectiveness <strong>of</strong> <strong>the</strong>
mechanisms and structures put in place to fight <strong>the</strong> HIV/AIDS epidemic. Dissemination <strong>of</strong>
information also varied according to level. For example, <strong>the</strong> disparity between what primary
and secondary schools receive at first hand was thought to have negatively <strong>impact</strong>ed on <strong>the</strong>
success <strong>of</strong> some school-based initiatives in primary schools. Linked to this, NGO-led peer
education was found to be more visible in secondary than in primary schools, since secondary
schools have a greater degree <strong>of</strong> autonomy in selecting external organizations <strong>the</strong>mselves.
There are also disparities between schools <strong>of</strong> <strong>the</strong> same level. During visits to primary
schools in Iringa Urban District, it was found that school guidance and counselling
committees and services, and peer education programmes had taken hold in very few
institutions. The low pr<strong>of</strong>ile was thought to be due to inadequate monitoring and evaluation.
The mechanisms for enforcing at <strong>the</strong> local level policy guidelines developed at <strong>the</strong> central
were also felt to be inadequate and consequently to have affected <strong>the</strong> extent to which
interventions had been implemented.
3.5.5 Target age group
Where peer education schemes, and HIV/AIDS education and life skills programmes
had been implemented in primary schools, <strong>the</strong>y were confined to classes V to VII. This
exclusion <strong>of</strong> younger pupils can be criticized for several reasons:
� Preventive education can only be truly effective if young people are informed and
protected right from <strong>the</strong> start. Therefore AIDS education must be introduced before
children become sexually active.
� Pregnancy cases prove that some children do become sexually active before <strong>the</strong>y reach
class V. This may be out <strong>of</strong> choice or <strong>the</strong>y may be forced into it: unfortunately cases <strong>of</strong>
rape against young girls are now very common.
� Although primary education is supposed to start at <strong>the</strong> age <strong>of</strong> six, some children begin
much later. Fur<strong>the</strong>rmore, Tanzania does not practice a policy <strong>of</strong> automatic promotion.
Therefore, it is likely that classes I to IV will contain pupils <strong>of</strong> mixed ages, including
many children who are much older than <strong>the</strong> ‘normal’ age for each class and who are
already sexually mature. Following this argument it would be more constructive to
institute a policy <strong>of</strong> age- ra<strong>the</strong>r than class-based counselling and education, to ensure that
such children are not excluded.
33

3.6 Additional problems
3.6.1 Educational Management Information Systems (EMIS)
The combined activities <strong>of</strong> <strong>the</strong> MoEC, NGOs, CBOs, FBOs and o<strong>the</strong>r agencies
generate huge amounts <strong>of</strong> data. This may only be adequately captured and monitored through
<strong>the</strong> use <strong>of</strong> an effective Educational Management Information System (EMIS). An EMIS is
required to ensure that information reaches its destination, is stored correctly, is easily
retrievable and that <strong>the</strong> receiver and originator are kept abreast <strong>of</strong> any new developments.
However, research findings reveal that no such system currently exists.
Creating an EMIS will not be an easy task, since district education departments and
institutions are poorly equipped to handle education sector data. For example, districts and
institutions do not maintain records on staff morbidity and absenteeism, or costs connected to
treatment, funerals and burials As a result, <strong>the</strong> MoEC can not accurately track and document
trends in staff supply and demand (see also Government <strong>of</strong> Malawi and UNDP, 2002), or
effectively budget for additional costs incurred.
3.6.2 Policy issues
As discussed above, <strong>the</strong> approach <strong>of</strong> <strong>the</strong> education sector has been to implement
HIV/AIDS interventions based on non-formal policy documents. However, this has been
nei<strong>the</strong>r sufficient nor effective in addressing HIV/AIDS in a wider context, because circular
and guidelines lack <strong>the</strong> legal backing for wider application and accountability.
All <strong>of</strong> <strong>the</strong> issues raised in <strong>the</strong>se final two sections will be fur<strong>the</strong>r discussed in <strong>the</strong>
chapter outlining <strong>the</strong> conclusions <strong>of</strong> <strong>the</strong> study, and will be used to draw out recommendations
for improving <strong>the</strong> sector response.
34

4. LEADERSHIP AND ADVOCACY
4.1 Internal advocacy for policy development and
implementation <strong>of</strong> interventions
The senior <strong>of</strong>ficers <strong>of</strong> <strong>the</strong> MoEC, that is <strong>the</strong> Permanent Secretary (<strong>the</strong> chief executive
<strong>of</strong>ficer), <strong>the</strong> CEO (responsible for <strong>the</strong> administration <strong>of</strong> <strong>the</strong> Ministry), and <strong>the</strong> departmental
directors take <strong>the</strong> principal leadership roles in advocating for policy development.
After a policy gap has been identified, <strong>the</strong> department or set <strong>of</strong> departments and
institutions with <strong>the</strong> requisite technical expertise are directed by <strong>the</strong> Permanent Secretary to
prepare a concept paper. In <strong>the</strong> case <strong>of</strong> HIV/AIDS policy, this paper is <strong>the</strong>n presented to <strong>the</strong>
AMC for discussion and approval. The CEO is <strong>the</strong> current focal point for <strong>the</strong> development <strong>of</strong>
<strong>the</strong> ESSP for <strong>the</strong> period 2003-2007. It is likely that <strong>the</strong> CEO will also take <strong>the</strong> leadership role
in advocating for <strong>the</strong> development <strong>of</strong> a dedicated education sector HIV/AIDS policy.
Eventual policy implementation will be coordinated by <strong>the</strong> ACU. However <strong>the</strong> progress and
outputs <strong>of</strong> <strong>the</strong> ACU need to be discussed by <strong>the</strong> TAC and <strong>the</strong>n vetted by both <strong>the</strong> AMC and
<strong>the</strong> Basic Education Development Committee (BEDC). The BEDC is <strong>the</strong> body responsible for
overseeing <strong>the</strong> development <strong>of</strong> education at all levels, from pre-primary to adult, ensuring that
it complements wider sector development goals. Within <strong>the</strong> framework <strong>of</strong> local government
reform, PORALG leaders acting as administrators <strong>of</strong> <strong>the</strong> education sector at regional and
district levels, also have powers to advocate for <strong>the</strong> implementation <strong>of</strong> an education sector
intervention.
Therefore, advocacy for <strong>the</strong> implementation <strong>of</strong> interventions is <strong>the</strong> combined
responsibility <strong>of</strong> leaders at many different levels <strong>of</strong> <strong>the</strong> system. It is far more effective,
however, when it comes from leaders positioned at upper levels <strong>of</strong> <strong>the</strong> MoEC hierarchy, as
witnessed by <strong>the</strong> speeches that <strong>the</strong>y make and guidelines that <strong>the</strong>y give to <strong>of</strong>ficials at lower
levels.
In <strong>the</strong> civil service <strong>the</strong>re are established mechanisms for both internal and external
communications. In <strong>the</strong> case <strong>of</strong> internal advocacy (i.e. practices directed at ministry staff)
<strong>the</strong>se include speeches, seminars, workshops, guidelines and memos and are <strong>the</strong> responsibility
<strong>of</strong> all <strong>of</strong>ficials, from <strong>the</strong> Permanent Secretary down to <strong>the</strong> peer educators.
A number <strong>of</strong> practices have been initiated or enhanced at MoEC headquarters and in
<strong>the</strong> districts to fur<strong>the</strong>r improve internal advocacy:
� Leaders continually talk about issues and promote activities related to HIV/AIDS, during
internal meetings, workshops, festivals, seminars and graduation ceremonies.
� District leaders communicate education sector needs and strategies on HIV/AIDS to staff
members, pupils and students.
� Education sector needs related to HIV/AIDS are communicated to <strong>the</strong> full council with
<strong>the</strong> objective <strong>of</strong> raising awareness and <strong>of</strong> soliciting funds and inter-sectoral support for
strategies.
35

� Leaders keep HIV/AIDS in <strong>the</strong> education sector on <strong>the</strong> political agenda by consistently
explaining issues and arguing for action.
� Workshops and seminars serve to communicate education sector needs and explain <strong>the</strong>
associated issues to school heads and teachers.
4.2 External advocacy for policy development and
implementation <strong>of</strong> interventions
External advocacy, directed at NGOs, school pupils and <strong>the</strong> wider community, is <strong>the</strong>
responsibility <strong>of</strong> senior <strong>of</strong>ficials, including <strong>the</strong> Communications Officer, Permanent Secretary
and Minister. Officials communicate with <strong>the</strong> general public through <strong>the</strong> mass media, as well
as by preparing speeches, cabinet papers, memos and press releases. Care is taken to ensure
that <strong>the</strong>se remain in line with <strong>the</strong> strategies agreed upon by <strong>the</strong> AMC and BEDC.
In addition to <strong>the</strong> practices described in <strong>the</strong> last chapter, <strong>the</strong> following practices have
been established or enhanced at all levels to facilitate external advocacy:
� Leaders explain issues and promote activities related to HIV/AIDS during external
meetings, workshops, festivals, seminars, and graduation ceremonies.
� The MoEC solicits funds for HIV/AIDS interventions from development partners.
� District level <strong>of</strong>ficials appeal for funding <strong>of</strong> in-school HIV/AIDS activities in
presentations to full council meetings.
� NGOs, mandated by <strong>the</strong> MoEC, advocate pupils and students to adopt safe sex practices,
including promoting <strong>the</strong> routine use <strong>of</strong> condoms.
4.3 Visible gaps in leadership and advocacy
Despite <strong>the</strong> commitment <strong>of</strong> education sector leaders at all levels to <strong>the</strong> prevention and
control <strong>of</strong> HIV/AIDS and <strong>impact</strong> mitigation, a number <strong>of</strong> leadership and advocacy gaps were
identified:
36
� insufficient interest in <strong>the</strong> <strong>impact</strong> <strong>of</strong> HIV/AIDS from some leaders in <strong>the</strong> education
sector;
� mistrust <strong>of</strong> HIV/AIDS prevention and control interventions in <strong>the</strong> education sector,
particularly <strong>of</strong> <strong>the</strong> policy <strong>of</strong> promoting <strong>the</strong> use <strong>of</strong> condoms;
� a lack <strong>of</strong> initiatives among education sector leaders to advocate for prevention and
control <strong>of</strong> HIV/AIDS and <strong>impact</strong> mitigation;
� inadequate numbers <strong>of</strong> leaders at all levels with HIV/AIDS skills and knowledge;
� inadequate financial resources to tackle prevention and control <strong>of</strong> HIV/AIDS and
<strong>impact</strong> mitigation in <strong>the</strong> education sector;

� failure to use existing radio programmes for schools to widely disseminate HIV/AIDS
information;
� a lack <strong>of</strong> capacity and skills at <strong>the</strong> district and institutional levels to coordinate
HIV/AIDS prevention, control and <strong>impact</strong> mitigation activities between different
actors (NGOs, CBOs, FBOs etc.).
In <strong>the</strong> opinion <strong>of</strong> <strong>the</strong> authors, <strong>the</strong>se points <strong>of</strong> weakness can be principally attributed to
<strong>the</strong> lack <strong>of</strong> a sector-specific HIV/AIDS policy, as highlighted in <strong>the</strong> proceeding chapter. This
lack <strong>of</strong> policy, coupled with <strong>the</strong> gaps identified, is also evidence <strong>of</strong> <strong>the</strong> insufficient
commitment <strong>of</strong> many in <strong>the</strong> sector to fighting <strong>the</strong> epidemic, as well as <strong>of</strong> <strong>the</strong> more practical
lack <strong>of</strong> information and knowledge about <strong>the</strong> sectoral <strong>impact</strong> <strong>of</strong> <strong>the</strong> epidemic. Both <strong>of</strong> <strong>the</strong>se
problems urgently need to be remedied if <strong>the</strong> issues identified above are to be remedied.
4.3.1 Tackling cultural practices
Various cultural practices that contribute to <strong>the</strong> spread <strong>of</strong> AIDS were briefly outlined
in Chapter 2. Behaviours resulting from long-established cultural assumptions and beliefs, for
example that sex with a minor may cure disease, tend not to be discussed in advocacy
campaigns. However, education sector leaders must ensure that <strong>the</strong>y are fully debated and that
<strong>the</strong> risks involved are highlighted to young people, for example through peer education
sessions.
4.4 Steps needed to create a conducive environment for
effective leadership and advocacy
Effective leadership and advocacy are characterized by <strong>the</strong> firm, consistent and visible
support <strong>of</strong> leaders at all levels. Although senior leaders in Tanzania, such as His Excellency
<strong>the</strong> President and <strong>the</strong> Honourable Prime Minister, have been consistently highlighting
HIV/AIDS prevention, control and <strong>impact</strong> mitigation in <strong>the</strong>ir speeches and press conferences,
research findings have indicated that <strong>the</strong> overall steps taken have not been adequate. The
situation could be improved by:
� implementing an effective monitoring and evaluation plan to track <strong>the</strong> progress <strong>of</strong> <strong>the</strong>
AIDS education programme over time;
� ensuring that <strong>the</strong> current EMIS incorporates information on HIV/AIDS, so that leaders
have adequate information upon which to base action in <strong>the</strong> sector;
� sensitizing leaders at all levels to <strong>the</strong> importance <strong>of</strong> AIDS education in <strong>the</strong>ir respective
areas <strong>of</strong> jurisdiction;
� providing instruction for senior leaders in <strong>the</strong> MoEC with <strong>the</strong> aim <strong>of</strong> improving <strong>the</strong>ir
knowledge <strong>of</strong> <strong>the</strong> HIV/AIDS multi-sectoral framework, including <strong>the</strong> structural
location, scope and functions <strong>of</strong> TACAIDS;
� encouraging education sector leaders at all levels to act on <strong>the</strong> presidential directive
that required <strong>the</strong>m to make HIV/AIDS a key topic at all available opportunities;
37

38
� exploring <strong>the</strong> use <strong>of</strong> wider forums to share HIV/AIDS issues, ra<strong>the</strong>r than being limited
to traditional avenues such as seminars and conferences;
� encouraging MoEC <strong>of</strong>ficials to make maximum use <strong>of</strong> <strong>the</strong> mass media and to make
periodic press statements that stipulate HIV/AIDS interventions in <strong>the</strong> sector.

5.1 Policy
5. CONCLUSIONS AND RECOMMENDATIONS
The Ministry has been active in prevention, control and <strong>impact</strong> mitigation ever since
<strong>the</strong> inception <strong>of</strong> <strong>the</strong> national programme against HIV/AIDS in 1985. Interventions are
delivered through <strong>the</strong> national HIV/AIDS policy <strong>of</strong> 2001, which prescribes and empowers <strong>the</strong>
MoEC to work closely with TACAIDS to deliver appropriate in-school interventions. A
fur<strong>the</strong>r mandate to develop a sectoral strategic framework and directives on HIV/AIDS for
schools and workplaces has been given to <strong>the</strong> education sector through <strong>the</strong> national multisectoral
strategic framework on HIV/AIDS.
The Ministry’s concerted efforts were expressed through <strong>the</strong> issuing <strong>of</strong> Education
Circular No. 3 <strong>of</strong> 1993, which established <strong>the</strong> school HIV/AIDS education programme. The
programme was later expanded to cover all education sector staff, through Circular No. 3
issued in 2000. Many different methods have been used to deliver HIV/AIDS information to
sector staff, including issuing guidelines and directives, and conducting seminars.
However despite all <strong>of</strong> <strong>the</strong>se measures, <strong>the</strong> interventions have been nei<strong>the</strong>r sufficient
nor effective in addressing <strong>the</strong> problems resulting from <strong>the</strong> AIDS epidemic. The authors
attribute this principally to <strong>the</strong> absence <strong>of</strong> a dedicated education sector policy upon which a
strategic framework could be formulated. The mechanisms for <strong>the</strong> collaboration and exchange
<strong>of</strong> information, <strong>the</strong> coordination <strong>of</strong> activities and accountability at sectoral level, which would
have been outlined in such a policy, cannot be constructed on <strong>the</strong> basis <strong>of</strong> guidelines alone.
Consequently, <strong>the</strong>re is insufficient co-operation and even competition <strong>of</strong> priorities between
NGOs, CBOs and <strong>the</strong> education sector.
5.1.1 Recommendations
Policy formulation should precede enactment <strong>of</strong> law and <strong>the</strong> subsequent preparation <strong>of</strong>
circulars, regulations, guidelines and directives. It is impossible to realize effective and
sustainable mainstream AIDS activities within <strong>the</strong> education sector without first creating a
dedicated sectoral policy. The Ministry should <strong>the</strong>refore formulate a formal sector-specific
policy on HIV/AIDS, which should form part <strong>of</strong> <strong>the</strong> current education and training policy,
ra<strong>the</strong>r than being a separate and independent programme. Mainstreaming HIV/AIDS means
including it in all key policy and strategy documents.
The section <strong>of</strong> <strong>the</strong> policy dealing with HIV/AIDS would provide <strong>the</strong> framework,
direction and general principles for prevention, care and support <strong>of</strong> those infected and affected
by <strong>the</strong> disease, including Ministry staff and those in affiliated institutions, and in mitigation <strong>of</strong>
<strong>the</strong> <strong>impact</strong> <strong>of</strong> HIV/AIDS. Issues that would need to be addressed include:
� <strong>the</strong> creation <strong>of</strong> a code <strong>of</strong> conduct for teachers, dealing explicitly with HIV/AIDS;
� <strong>the</strong> processing <strong>of</strong> pensions and death gratuities;
� <strong>the</strong> management <strong>of</strong> infected and affected teachers, for example meeting transfer or
reduced workload requests.
39

The policy should also cater for <strong>the</strong> interests <strong>of</strong> pupils and students, as well as trainees
at teacher training colleges.
The main aim should be <strong>the</strong> creation <strong>of</strong> an environment that is conducive to <strong>the</strong>
formulation <strong>of</strong> appropriate interventions, and which will in turn be effective in preventing and
controlling HIV/AIDS and STI infections, protecting and supporting vulnerable groups, and
mitigating <strong>the</strong> social and economic <strong>impact</strong> <strong>of</strong> HIV/AIDS. The policy would also prescribe <strong>the</strong>
budgeting process, methods <strong>of</strong> raising funds, <strong>the</strong> mobilization <strong>of</strong> materials and human
resources, and <strong>the</strong> identification <strong>of</strong> priority areas for HIV/AIDS prevention and control
activities.
The development <strong>of</strong> such a policy would have to be participatory and interactive in
nature, involving TACAIDS, <strong>the</strong> MoEC and its affiliated institutions, PORALG, <strong>the</strong> Ministry
<strong>of</strong> Labour, Youth Development and Sports, <strong>the</strong> MoH, NGOs, CBOs, FBOs and any o<strong>the</strong>r
MoEC stakeholders.
5.2 Leadership
Education sector leaders have <strong>the</strong> crucial responsibility <strong>of</strong> implementing HIV/AIDS
activities, but <strong>the</strong>re is little evidence <strong>of</strong> committed and sustained leadership on HIV/AIDS
issues. Besides <strong>the</strong> problem <strong>of</strong> not perceiving <strong>the</strong> epidemic as an educational issue, <strong>the</strong>
education sector has inadequate resources in terms <strong>of</strong> manpower, finance, equipment and
supplies. For example, peer educators at MoEC headquarters and in schools have no IEC
materials to use with clients. Leaders also lack <strong>the</strong> legal framework and means to effectively
implement activities. Fur<strong>the</strong>rmore <strong>the</strong> education sector suffers from a general lack <strong>of</strong>
supervision, monitoring and evaluation. Consequently under prevailing conditions HIV/AIDS
programmes cannot be efficiently designed, implemented or revised.
5.2.1 Recommendations
Some education sector leaders are poorly informed about <strong>the</strong> framework for a multisectoral
response to <strong>the</strong> HIV/AIDS epidemic and <strong>the</strong> importance <strong>of</strong> AIDS education
interventions in <strong>the</strong>ir respective areas. This must be urgently remedied: education sector
leaders must receive adequate training.
In order to implement activities effectively, education sector leaders must also have
access to instructional support materials, both at Ministry headquarters and in schools. It is
<strong>the</strong>refore advised that <strong>the</strong> MoEC ensures that peer educators are adequately equipped with
IEC materials.
It was found that <strong>the</strong> responsibilities <strong>of</strong> MoEC peer educators are not reflected in job
descriptions or taken into account when considering staff for promotion. As a result, <strong>the</strong>
assignment is not taken seriously. It is advised that <strong>the</strong> MoEC gives token incentives and
possibly awards peer educators with additional assignments in recognition <strong>of</strong> <strong>the</strong> extra work
that <strong>the</strong>y carry out.
The training and replacement <strong>of</strong> education sector staff has not responded to <strong>the</strong> <strong>impact</strong>
<strong>of</strong> HIV/AIDS on <strong>the</strong> sector. If nothing is done about this, <strong>the</strong> sector risks facing a damaging
40

shortage <strong>of</strong> key personnel. To avoid this, it is advised that training and replacement,
particularly <strong>of</strong> subject specialists, should reflect <strong>the</strong> <strong>impact</strong> <strong>of</strong> HIV/AIDS on <strong>the</strong> sector.
Concrete facts and figures are essential for effective leadership and advocacy. One <strong>of</strong>
<strong>the</strong> greatest challenges is precisely <strong>the</strong> lack <strong>of</strong> reliable data about <strong>the</strong> <strong>impact</strong> <strong>of</strong> HIV/AIDS on
teachers and pupils. This is largely because MoEC headquarters and <strong>the</strong> district education
<strong>of</strong>fices do not have an effective EMIS to monitor <strong>the</strong> <strong>impact</strong> <strong>of</strong> HIV/AIDS in <strong>the</strong> education
sector. It is strongly advised that <strong>the</strong> current EMIS be made HIV/AIDS sensitive. The
programme monitoring capacity should be increased, as should <strong>the</strong> capacity for collecting,
storing, disseminating and retrieving information using electronic equipment. Such
improvements will facilitate <strong>the</strong> formulation <strong>of</strong> sound training and replacement strategies and
aid staff deployment. They will also enable comparisons to be made amongst different types
<strong>of</strong> institutions (e.g. public and private schools, teacher training colleges etc.), studying
absenteeism and measuring <strong>the</strong> effectiveness <strong>of</strong> interventions.
5.3 Advocacy
The mass media play a very important role for advocacy through educating, informing
and entertaining <strong>the</strong> public. It is a very effective means <strong>of</strong> reaching many people at <strong>the</strong> same
time and has been used extensively by senior leaders. However, <strong>the</strong> media used should be
selected carefully and with reference to <strong>the</strong> target audience. With an illiterate population, for
example, <strong>the</strong> written word (newspapers, flyers, circulars etc.) will not be very effective, whilst
in poverty-ridden communities <strong>the</strong> spoken word (television, radio, etc.) will only have limited
<strong>impact</strong> because <strong>of</strong> <strong>the</strong> relatively high cost <strong>of</strong> receiving equipment.
Seminars, conferences and workshops have also been used extensively as vehicles to
deliver HIV/AIDS interventions, although <strong>the</strong>y may be open to abuse. For example,
Shellukindo et al. (2000) remark that sometimes <strong>the</strong>se activities are not taken seriously by
participants and have become income-generating activities for those involved in AIDS control
and prevention.
Some religious leaders and education sector <strong>of</strong>ficials do not support advocacy for
condom promotion and use in schools. They regard HIV/AIDS as God’s punishment to
sinners and promotion <strong>of</strong> condom use as encouraging people to commit adultery or to indulge
in promiscuous activities. Shellukindo et al. (2000: 45) remind <strong>the</strong> readers and those opposed
to condom use and promotion that, “If we cannot prevent people from breaking <strong>the</strong> sixth
commandment (you shall not commit adultery) we should at least prevent <strong>the</strong>m from breaking
<strong>the</strong> fifth commandment (you shall not kill). Keeping silent about condoms is a sin because it
means assisting <strong>the</strong> spread <strong>of</strong> illness and death.”
5.3.1 Recommendations
In all cases, <strong>the</strong> effectiveness <strong>of</strong> <strong>the</strong> advocacy approaches described above have not
been assessed, with regard to timing, <strong>the</strong> target group, <strong>the</strong> socioeconomic environment <strong>of</strong> <strong>the</strong>
target group, etc. It is highly recommended that <strong>the</strong>se approaches be evaluated in order to
measure <strong>the</strong>ir efficacy and effectiveness.
41

Finally and most importantly, <strong>the</strong> MoEC should develop and implement ongoing plans
for HIV/AIDS advocacy in <strong>the</strong> education sector, including outlining leadership roles and
identifying role models.
42

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Tanzania MoH. 2001. NACP HIV/AIDS/STD surveillance report, no. 15, December 2001.
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?OpenDocument.
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APPENDIX 1
A LIST OF PEOPLE INTERVIEWED
Name Position Institution
Mr. A. Mwakalinga Director <strong>of</strong> Policy and Planning MoEC
Mr. O. Mhaiki Director <strong>of</strong> Basic Education MoEC
Mr. M. Msongo Director <strong>of</strong> Administration and Personnel MoEC
Ms. R.P. Ms<strong>of</strong>fe Acting Director <strong>of</strong> School Inspection MoEC
Mr. B. Buretta Director <strong>of</strong> Secondary Education MoEC
Dr. D.K. Ndagalla Director <strong>of</strong> Cultural Development MoEC
Dr. A.L. Temba Director <strong>of</strong> Policy and Planning TACAIDS
Dr. B. Fimbo Head <strong>of</strong> IEC Unit NACP
Mrs. M. Sitta President TTU
Ms. P.E. Olekambainei Executive Secretary TSC
Dr. F.C. Kigadye Director CSSC
Mr. Khatibu Education Officer BAKWATA
Mr. Mwaipopo Education Secretary TAPA
Mr. A. Chembere Education Officer Agha Khan Education
Services
Mr. S. Maduhu Regional Education Officer Iringa Region
Mr. A. Midelo District Development Director Iringa Urban District
Mr. D. Feruzi Mayor Iringa Urban District
Mr. A.A. Kameka District Education Officer Iringa Urban District
Dr. M. Mpangachuma District Medical Officer Iringa Urban District
Mr. Mung’ong’o District School Inspector Iringa Urban District
Mr. Kihwili District Teachers Union Secretary Iringa Urban District
Mr. Mwachumbe Headmaster Lugalo Secondary School
Mrs. C.N. Mgonja Headmistress Iringa Girls Secondary
School
Mr. W. Kyando Head teacher Mkimbizi Primary School
Ms. F. Abubakar Head teacher Mlandege A Primary School
Mr. A. Admini Head teacher Mlandege B Primary School
Mr. A. Ghemela Ward Education Coordinator Ilala Ward
Mr. V. Mvanda Ward Education Coordinator Mlandege Ward
Mr. C. Ferla Director SPW, Iringa Region
Mr. P. Njuyuwi Director IDYDC
Mr. J. Sizya Programme Officer INGONET
Ms. B. Massima Programme Officer TAHEA, Iringa Region
Mr. D. Kapufi Programme Officer IDYDC
45

APPENDIX 2
GROUPS OF PEOPLE WHO PARTICIPTED IN FOCUS GROUP
DISCUSSIONS
Category or cadre Number <strong>of</strong>
FGDs
Number <strong>of</strong>
participants
MoEC headquarters peer educators 1 8
MoEC headquarters middle cadre staff 1 9
MoEC headquarters low cadre staff – female 1 10
MoEC headquarters low cadre staff – male 1 10
Secondary school teachers 4 35
Primary school teachers 5 46
Secondary school students – female 3 29
Secondary school students – male 3 30
Primary school pupils – female 5 50
Primary school pupils – male 5 50
47

APPENDIX 3
TANZANIA RESEARCH AND RESULTS VALIDATION TEAMS
Data collection team
Pr<strong>of</strong>. Athanas Kauzeni Team leader
Dr. Nesta Sekwao Office <strong>of</strong> <strong>the</strong> CEO, MoEC
Dr. Letitia Sayi ACU, MoEC
Ms. Hadija Maggid Directorate <strong>of</strong> Policy and Planning, MoEC
Ms. Ruth Sam Directorate <strong>of</strong> School Inspections, MoEC
Mr. Clarence Mwinuka Directorate <strong>of</strong> Basic Education, MoEC
Ms. Cecilia Makinyika School <strong>of</strong> Nursing, Muhimbili National Hospital
Dr. Vincent Mashinji School <strong>of</strong> Medicine, Muhimbili National Hospital
Mr. Ge<strong>of</strong>frey Mandara TSC
Mr. Clement Kihinga Associate researcher
Results validation workshop participants
Pr<strong>of</strong>. Athanas Kauzeni Team leader
Dr. Letitia Sayi ACU, MoEC
Dr. Gabriel Rugalema UNESCO/IIEP
Dr. Flora Kessy Economic and Social Research Foundation
Mr. Clarence Mwinuka Directorate <strong>of</strong> Basic Education, MoEC
Mr. Anthony Mtavangu TTU
Ms. Emma Sundberg Freelance consultant
Mr. Clement Kihinga Associate researcher
49